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These studies suggest Repatha (evolocumab) is not a statin but a PCSK9 inhibitor used to lower LDL cholesterol, often in conjunction with statin therapy.
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Repatha, also known by its generic name evolocumab, is a medication developed by Amgen for the treatment of hypercholesterolemia. It is a fully human monoclonal antibody that targets proprotein convertase subtilisin/kexin type 9 (PCSK9), a protein that plays a crucial role in the regulation of low-density lipoprotein cholesterol (LDL-C) levels in the blood .
Unlike statins, which work by inhibiting the enzyme HMG-CoA reductase to reduce cholesterol synthesis in the liver, Repatha functions by binding to PCSK9. PCSK9 is a protein that degrades LDL receptors on liver cells. By inhibiting PCSK9, Repatha increases the number of LDL receptors available to clear LDL-C from the bloodstream, thereby significantly lowering LDL-C levels .
Repatha has been shown to be highly effective in reducing LDL-C levels. Clinical trials have demonstrated that it can lower LDL-C by approximately 50-60% when used in combination with statins or as monotherapy in statin-intolerant patients . It is administered via subcutaneous injection, either every two weeks or once a month, depending on the dosage .
While both Repatha and statins aim to lower LDL-C levels, they do so through different mechanisms. Statins inhibit cholesterol synthesis, whereas Repatha enhances the clearance of LDL-C from the blood by preventing the degradation of LDL receptors . Repatha is particularly beneficial for patients who are unable to achieve their LDL-C targets with statins alone or who are statin-intolerant .
Repatha has been approved by regulatory authorities such as the FDA and the European Medicines Agency (EMA) for use in patients with heterozygous familial hypercholesterolemia, homozygous familial hypercholesterolemia, and clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-C despite maximally tolerated statin therapy . It is also approved for use in patients who cannot tolerate statins .
In summary, Repatha (evolocumab) is not a statin. It is a PCSK9 inhibitor that offers a different mechanism of action for lowering LDL-C levels. It is particularly useful for patients who cannot achieve their cholesterol goals with statins alone or who are intolerant to statins. Its efficacy and safety have been well-documented in various clinical trials, making it a valuable addition to the arsenal of lipid-lowering therapies .
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