Evolocumab shows secondary cardiovascular prevention benefit

  • Murphy SA & al.
  • JAMA Cardiol
  • 22 May 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Evolocumab added to statins is linked to decreased event rates for myocardial infarction (MI), stroke, and coronary revascularisation. 
  • These results from a prespecified secondary analysis of the FOURIER trial support “the benefit of continuing aggressive lipid-lowering therapy” for secondary prevention, say the authors.

Why this matters

  • Results of the primary analysis showed benefit of evolocumab in primary prevention.

Key results

  • The intervention group experienced reduced subsequent primary outcome events vs placebo: incidence rate ratio, 0.74 (95% CI, 0.65-0.85).
  • For every 1000 patients treated for 3 years, evolocumab was tied to 30 prevented second primary outcome events.
  • Most of the prevented second events (rate ratios; 95% CIs) were:
    • MI: 0.74 (0.65-0.84),
    • Stroke: 0.77 (0.64-0.93), and
    • Coronary revascularisation: 0.78 (0.71-0.87).
  • Cardiovascular death rate was similar between the 2 trial groups.

Study design

  • Randomised, placebo-controlled, double-blind trial of 27,564 patients with stable atherosclerotic disease on statins.
  • Primary endpoint: time to first cardiovascular death, MI, stroke, hospitalisation for unstable angina, coronary revascularisation.
  • Total cardiovascular events also analysed.
  • Funding: Amgen.

Limitations

  • Relatively short follow-up of median 2.2 years.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit