Evolocumab reduces cardiovascular mortality by lowering LDL-C levels

Currently, Cardiovascular diseases continue to position themselves as the main cause of mortality in the world and in Spain, where one of every three deaths is due to this pathology. Also, experts estimate that elevated LDL cholesterol (LDL-C), also known as “bad” cholesterol is responsible for one in four cardiovascular events that occur in our country. Although the data indicates that More than half of Spaniards have high cholesterolthe Study of Nutrition and Cardiovascular Risk in Spain (ENRICA) warns that 54 percent are still undiagnosed.

Based on these conclusions, from Amgen have presented the new data from the FOURIER-OLE open extension, during a Hot Line Session of Congress of the European Society of Cardiology (SEC). In this line, from the biotechnology they have warned that one in five patients who has suffered an acute myocardial infarction or a stroke, will have another in less than a year. And it is that, to have LDL cholesterol levels in the blood above 100 mg/dl —or 70 mg/dl in the case of patients who have had cardiovascular events— causes up to 60 percent of heart attacks and 40 percent of strokes.

The study, published in parallel in the scientific journal Circulationreflects that 80 percent of patients treated with evolocumab (Repatha, PCSK9 protein inhibitor), added to statin therapy, have achieved maintain cholesterol figures consistently below the 55 mg/dl recommended by clinical guidelines. In addition, as detailed by Amgen, they achieve a 58 percent reduction in LDL-C levels in a sustained and lasting manner, maintaining these figures also in week 260 of follow-up.

Having levels of LDL cholesterol in the blood above those clinically recommended causes up to 60% of heart attacks and 40% of strokes

After a median follow-up of up to five years, Amgen has observed that this reduction in cholesterol figures has also allowed reduce the relative risk of cardiovascular mortality by 23 percent Y 20 percent relative risk of having another major cardiovascular eventas observed in the 3,355 patients with established atherosclerotic disease treated with the drug—exposed to evolocumab for a maximum of 8.4 years when the extension and initial studies were combined—compared to 3,280 treated with placebo.

“These new results confirm that starting this treatment early for a long period of time can offer a greater reduction in cardiovascular risk and death, in addition to being well tolerated by patients,” says Miquel Balcells, medical director of Amgen for Spain. and Portugal.

In patients without acute myocardial infarction

For his part, after presenting the results at the congress, José Luis Zamorano, Head of the Cardiology Service at the Ramón y Cajal Hospital in Madrid, believes that “these data confirm that the intense reduction in LDL-C with evolocumab added to statins, reduces cardiovascular events and cardiovascular mortality”.

Evolocumab manages to keep cholesterol figures constantly below the 55 mg/dl recommended by clinical guidelines

“Therefore,” he continues, “the more we lower LDL cholesterol and the sooner we do it, the better. In addition, with a follow-up of up to eight years of the study, and given the safety of the treatment and chronicity of the disease, long-term treatment and compliance with therapeutic objectives should be insisted on”.

Based on these results, Amgen has concluded that evolocumab also studies have begun in patients without previous acute myocardial infarction or strokein the ongoing VESALIUS-CV study (NCT03872401).

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