1. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.
- Author
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Sabatine, Marc S, Giugliano, Robert P, Keech, Anthony C, Honarpour, Narimon, Wiviott, Stephen D, Murphy, Sabina A, Kuder, Julia F, Wang, Huei, Liu, Thomas, Wasserman, Scott M, Sever, Peter S, Pedersen, Terje R, and FOURIER Steering Committee and Investigators
- Subjects
FOURIER Steering Committee and Investigators ,Humans ,Cardiovascular Diseases ,Hypercholesterolemia ,Antibodies ,Monoclonal ,Anticholesteremic Agents ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Drug Therapy ,Combination ,Incidence ,Least-Squares Analysis ,Follow-Up Studies ,Double-Blind Method ,Aged ,Middle Aged ,Female ,Male ,Atherosclerosis ,Cholesterol ,LDL ,Antibodies ,Monoclonal ,Humanized ,Proprotein Convertase 9 ,Cardiovascular ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,General & Internal Medicine ,Medical and Health Sciences - Abstract
BackgroundEvolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain.MethodsWe conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years.ResultsAt 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P
- Published
- 2017