At the American Heart Association (AHA) Scientific Sessions 2017, study authors reported new subgroup analyses data from the FOURIER trial that evaluated Repatha (evolocumab; Amgen) added to statin therapy in high-risk patients with peripheral artery disease (PAD), and in patients with a history of heart attack. 

The data indicated a significant reduction in CV events such as myocardial infarction (MI) and stroke in this patient population. 

Specifically, one analysis demonstrated Repatha added to statin therapy improved clinical outcomes with significant reduction of CV events in patients with a history of PAD. The absolute risk reduction (ARR) at 2.5 years was greater in patients with PAD vs. those without PAD (4.1% vs. 1.5%). Also, treatment with Repatha lowered the LDL-C levels in patients with PAD from median 93 to 31mg/dL (P<0.001). 

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The other analysis that evaluated Repatha in high-risk patients who had a prior MI showed a greater ARR (~3% over 3 years) in patients with history of MI within 2 years vs. patients whose MI was >2 years (1%).  The relative risk reduction (RRR) was 24% with Repatha in patients with a history of MI within 2 years vs. 13% for patients whose MI history was >2 years.

“These analyses add to the growing body of evidence that Repatha significantly and consistently reduces cardiovascular event risk across a spectrum of high-risk cardiovascular patients,” said Sean E. Harper, MD, executive vice president of Research and Development at Amgen. 

Repatha, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, works by preventing PCSK9-mediated LDL receptor degradation and permitting it to recycle back to the liver cell surface. This increases the number of LDL receptors available to clear LDL from the blood, thereby lowering LDL-C levels. It is currently approved as an adjunct to diet and maximally tolerated statin therapy for treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease (ASCVD), who require additional lowering of LDL-C; and as adjunct to other LDL-lowering therapies (eg, statins, ezetimibe, LDL apheresis) in patients with homozygous familial hypercholesterolemia (HoFH) who require additional lowering of LDL-C.

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