10-Year CVD Risk Reduction for Alirocumab, Evolocumab Announced

PCSK9 inhibitors evaluated for CVD risk reduction
PCSK9 inhibitors evaluated for CVD risk reduction

WASHINGTON, DC—At the ACC.17 Scientific Session, researchers from The Jewish Hospital of Cincinnati, OH, presented 10-year cardiovascular disease (CVD) risk and low-density lipoprotein cholesterol (LDL-C) reduction calculations for alirocumab and evolocumab.

In the open-label, post-commercial study, 107 patients were followed for median 24 weeks on alirocumab 75mg, alirocumab 150mg, or evolocumab 140mg every 2 weeks. A team of researchers, led by Ilana Schlam, assessed absolute and percent LDL-C reduction as well as 10-year percent CVD risk reduction, using ACC/AHA and Framingham calculators. 

Of the total patients, 43 had heterozygous familial hypercholesterolemia (HeFH), 38 had CVD, and 26 had both HeFH and CVD. Most of the study patients were Caucasian (86%) with 17% having diabetes and 62% taking antihypertensive agents. 

Prior to initiating alirocumab or evolocumab, 35% of patients were taking a statin and 65% were statin-intolerant. 

Researchers found that LDL-C was reduced to median 64mg/dL for patients on alirocumab 75mg, 70mg/dL for alirocumab 150mg, and 65mg/dL for evolocumab 140mg, which correlated to 45%, 64%, and 63% reductions, respectively.

The 10-year calculated National Institutes of Health (NIH) percent CVD risk was lowered by 37% in the alirocumab 75mg group, 50% in the alirocumab 150mg group, and by 54% in the evolocumab 140mg group. The 10-year American Heart Association (AHA) percent CVD risk was lowered by 21% in the alirocumab 75mg group, 35% in the alirocumab 150mg group, and by 32% in the evolocumab 140mg group. 

"The 3 most common adverse events were flu-like myalgia, respiratory tract infection, and injection site reaction, which did not differ between alirocumab and evolocumab," added Schlam. 

For high-risk patients with both HeFH and CVD, treatment with alirocumab (75mg and 150mg) and evolocumab (140mg) safely decreased LDL-C by 45%–64%, with reductions in median LDL-C to 64–75mg/dL.