Repatha Decreases Risk of Cardiovascular Disease-Related Death

According to recent research released at the American College of Cardiology’s 2017 Annual Scientific Session, use of the PCSK9 inhibitor Repatha (evolocumab; Amgen) significantly reduced the risk for death by lowering levels of low-density lipoprotein, also known as “bad cholesterol.” The research was also published in the New England Journal of Medicine.

“With this trial, we now have definitive data that by adding evolocumab to a background of statin therapy, we can significantly improve cardiovascular outcomes and do so safely,” Marc S Sabatine, MD, MPH, the Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine at Brigham and Women’s Hospital in Boston, and lead author of the study, said in a press release “I think these results are very good news for patients with atherosclerotic disease, who remain at high risk for these events.”

The researchers conducted a randomized, double-blind, placebo-controlled trial including 27,564 patients with atherosclerotic cardiovascular disease and high levels of low-density lipoprotein. Study participants were classified into two study groups, an intervention group that received Repatha subcutaneous injections and a control group which received placebo subcutaneous injections. 

The primary endpoints included frequency of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. According to the study results, Repatha reduced the risk of events in the primary endpoint by 15%. Furthermore, researchers found that after the first year, Repatha reduced the study’s secondary endpoints by 25%—including risk of cardiovascular death, heart attack, or stroke.

Additionally, the researchers found that Repatha lowered low-density lipoprotein levels by 59% compared to placebo. 

“Consistent with data from statin trials, it takes time for low-density lipoprotein lowering to translate to healthier arteries,” Dr Sabatine said. “We’ve never been able to plumb these depths before. These data strongly suggest that patients benefit from lowering low-density lipoprotein cholesterol well below current targets. We need to treat low-density lipoprotein cholesterol more aggressively, and now we have a new validated means to do so.”

In a related editorial, Robin PF Dullaart, MD, PhD, of the University Medical Center Groningen in the Netherlands, lauded this study as “a landmark trial providing formal evidence that treatment targeted at PCSK9 inhibition confers additional cardiovascular benefit beyond that achieved by lipid-lowering treatment alone.”—David Costill