GLAGOV: Does Evolucumab Affect the Progression of CHD?
The addition of PCSK9 inhibitors in the treatment of coronary heart disease (CHD) patients already taking statins showed incremental benefits on the progression of coronary atherosclerosis, according to the results of the GLAGOV Trial presented Nov. 15 during AHA 2016 and simultaneously published in the Journal of the American Medical Association.
Steven E. Nissen, MD, MACC, a past president of the ACC, et al., led the first intravascular outcome trial testing the effects of a PCSK9 inhibitor on the regression or progression of coronary atherosclerosis as measured by intravascular ultrasound. The study was a double-blind, placebo-controlled trial of 968 statin-treated patients with established CHD at 226 sites in 32 countries. The patients’ average age was 60, 72 percent were male, 24 percent were smokers and 21 percent were diabetic.
Statin-treated patients were randomly assigned to take either the PCSK9 inhibitor, evolocumab, (420 mg) monthly or placebo for 78 weeks. Patients underwent an intravascular ultrasound examination of a single coronary artery during a clinically-indicated angiogram at baseline and then repeated at end of the study.
The results of the study show that the percent atheroma volume decreased in patients treated with evolocumab compared to those treated with the placebo after 76 weeks of treatment. Further, the patients treated with evolocumab achieved lower mean, time-weighted LDL-C levels, and evolocumab induced plaque regression in a greater percentage of patients than the placebo.
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