Evolocumab: A Review in Hyperlipidemia
- Keating GM
- Evolocumab: A Review in Hyperlipidemia. Am J Cardiovasc Drugs 2016;16:67-78.
The following are key points to remember about the role of evolocumab in the management of hyperlipidemia:
- Evolocumab is a monoclonal antibody that targets proprotein convertase subtilisin/kexin 9 (PCSK9).
- Evolocumab was recently approved for use in primary hypercholesterolemia as well as familial hypercholesterolemia (heterozygous and homozygous).
- Evolocumab reduces low-density lipoprotein cholesterol (LDL-C) by as much as 77% when added to statin therapy in patients with primary hypercholesterolemia, 68% in heterozygous familial hypercholesterolemia, and 31% in homozygous familial hypercholesterolemia.
- Current guidelines have yet to incorporate the role of evolocumab in the management of hypercholesterolemia. However, based on studies, it would seem to be a reasonable choice in patients who have not achieved the desired LDL-C reduction while already on statins or those who are statin intolerant.
- No dose adjustment is needed in patients with mild to moderate hepatic or renal impairment.
- Evolocumab is generally well tolerated with no significant safety concerns noted to date.
- Evolocumab is administered by subcutaneous injection either once or twice monthly.
- A large trial is underway to evaluate the effect of evolocumab on cardiovascular outcomes.
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