Evolocumab for Lowering LDL Cholesterol

Mechanism of Action and Efficacy

The American College of Cardiology recommends evolocumab as an adjunct to diet and statin therapy to lower LDL cholesterol levels, with a significant reduction in circulating LDL cholesterol levels, typically by 50-65% 1
The American College of Cardiology suggests that when added to maximally tolerated statin therapy, evolocumab 140 mg every 2 weeks and 420 mg every 4 weeks reduces LDL-C by an additional 64% and 58%, respectively 2

The American College of Cardiology indicates that evolocumab is FDA-approved for lowering LDL-C in adults with primary hyperlipidemia, reducing the risk of MI, stroke, and coronary revascularization in adults with established atherosclerotic cardiovascular disease, and lowering LDL-C in adults and pediatric patients with homozygous familial hypercholesterolemia 3
The American Heart Association implies that evolocumab is particularly beneficial for patients with familial hypercholesterolemia, high-risk patients unable to tolerate high-intensity statin therapy, and patients unable to achieve >50% LDL cholesterol reduction on statin therapy 1
The European Heart Association notes that evolocumab appears well-tolerated in trials up to 78 weeks in duration, with common adverse effects including nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions 4

The American College of Cardiology recommends administering evolocumab subcutaneously in the thigh, abdomen, or upper arm, with dosing regimens of 140 mg every 2 weeks or 420 mg once monthly for adults with established ASCVD or primary hypercholesterolemia, and 420 mg once monthly for homozygous FH 3