Author + information
- Ilana Schlama,b,
- Ali Hudaa,b,
- Sarah H. Mina,b,
- Christopher Mahidaa,b,
- Parth Shaha,b,
- Ping Wanga,b,
- Naila Goldenberga,b and
- Charles Gluecka,b
Background: We assessed safety, efficacy, and low density lipoprotein cholesterol (LDLC) reduction beyond entry LDLC–lowering regimens, and calculated 10-yr % cardiovascular disease (CVD) risk, giving alirocumab (ALI) and evolocumab (EVO), in an open label, post-commercial study.
Methods: 107 patients were followed for median 24 weeks on ALI 75 mg (n=33) or 150mg (n=30), or EVO 140mg (n=44) every 2 weeks. We assessed absolute and % LDLC reduction and 10-year % CVD risk reduction, using ACC/AHA and Framingham (NlH) calculators.
Results: Of the 107 patients, 43 had heterozygous familial hypercholesterolemia (HeFH), 38 CVD, and 26 both HeFH and CVD. Median age was 64 years, 59 were women, 48 men, 86% Caucasian, 12% African-Americans, 17% diabetic, 62% on anti-hypertensive medications, and 6% smokers. Before starting ALI-EVO, 37 patients (35%) were taking a statin; 70 (65%) were statin intolerant. LDLC was lowered to median values of 64, 70, and 65 mg/dL on ALI 75, 150, and EVO 140 mg, representing 45%, 64%, and 63% reductions. Ten-year calculated NlH % CVD risk was lowered 37% (ALI 75 mg), 50% (ALI 150mg), and 54% (EVO 140mg), and (AHA) % CVD fell 21% (ALI 75mg), 35% (ALI 150 mg), and 32% (EVO 140mg). The 3 most common adverse events were flu-like myalgia 10.3%, respiratory tract infection 6.5%, and injection site reaction (4.6%), which did not differ between ALI and EVO.
Conclusions: In a high-risk cohort with HeFH and CVD, ALI 75 and 150 mg and EVO 140 mg safely lowered LDLC by 45% to 64%, lowering median LDLC to 64 to 70 mg/dl.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-064
- 2017 American College of Cardiology Foundation