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The results of the recently published FOURIER trial have shown a reduction in cardiovascular events with addition of the PCSK9 inhibitor evolocumab (Repatha) to statin therapy in patients with atherosclerotic cardiovascular disease (ASCVD).
EVOLOCUMAB — Evolocumab is a human IgG2 monoclonal antibody injected subcutaneously every two weeks or once monthly. It targets PCSK9 (proprotein convertase subtilisin kexin type 9) and prevents it from binding to LDL receptors, resulting in increased LDL receptor expression and increased hepatic uptake of LDL-cholesterol (LDL-C). Like alirocumab (Praluent), the other FDA-approved PCSK9 inhibitor, evolocumab has been found to reduce LDL-C levels by about 55-60% when added to statin therapy, and it is generally well tolerated.1 Alirocumab has not yet been shown to improve cardiovascular outcomes.
- Evolocumab (Repatha) – a second PCSK9 inhibitor to lower LDL-cholesterol. Med Lett Drugs Ther 2015; 57:140.
- Alirocumab (Praluent) to lower LDL-cholesterol. Med Lett Drugs Ther 2015; 57:113.
- Writing Committee. 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2016; 68:92.
- Lipid-lowering drugs. Med Lett Drugs Ther 2016; 58:133.
- RP Dullaart. PCSK9 inhibition to reduce cardiovascular events. N Engl J Med 2017 March 17 (epub).
- MS Sabatine et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017 March 17 (epub).
- Approximate WAC. WAC = wholesaler acquisition cost or manufacturer's published price to wholesalers; WAC represents a published catalogue or list price and may not represent an actual transactional price. Source: AnalySource® Monthly. April 5, 2017. Reprinted with permission by First Databank, Inc. All rights reserved. ©2017. www.fdbhealth.com/policies/drug-pricing-policy.