- Evolocumab added to high-intensity statins after acute coronary syndrome (ACS) results in more than 95% of patients achieving low-density lipoprotein cholesterol (LDL-C) targets.
- The combination was well tolerated in this randomised, placebo-controlled trial.
Why this matters
- This proprotein convertase subtilisin/kexin type 9 (PCSK9) antibody has not been studied before in the acute post-ACS in-hospital setting, say these authors.
- At week 8, mean LDL-C decreased from:
- 3.61 to 0.79 mmol/L with evolocumab; vs
- 3.42 to 2.06 mmol/L with placebo; and
- Difference in mean percentage change from baseline: −40.7% (95% CI, −45.2% to −36.2%; P<.001>
- By week 8, LDL-C target of
- 95.7% in the evolocumab group; vs
- 37.6% with placebo; and
- Mean differences:
- −55.8% (95% CI, −70.1% to −41.6%) for evolocumab, vs
- −36.5% (95% CI, −40.5% to −32.5%; Pinteraction<.001>
- Randomised, placebo-controlled, double-blind trial, 308 patients in hospital post-ACS, from January 23, 2018 to March 8, 2019, with high LDL-C, on a high-intensity statin ≥4 weeks.
- Patients randomly allocated to 420 mg subcutaneous evolocumab or placebo.
- Primary endpoint: percentage change in LDL-C from baseline to 8-week follow-up.
- Funding: Amgen.
- Modest sample size.