Repatha efficacy and dosage
Pro Research Analysisby 
Searched over 200M research papers
Repatha (Evolocumab) Dosage Recommendations
Repatha (evolocumab) is administered as a subcutaneous injection. The standard adult dosage is either 140 mg every two weeks or 420 mg once a month. For adults with homozygous familial hypercholesterolemia (HoFH), the recommended dose is 420 mg once a month. These dosing options are available as single-use prefilled autoinjectors or syringes, and patients can self-administer the medication at home 1234.
Efficacy of Repatha in Lowering LDL Cholesterol
Repatha is a monoclonal antibody that targets PCSK9, a protein that reduces the number of LDL receptors on liver cells. By blocking PCSK9, Repatha increases the number of LDL receptors, which helps remove more LDL cholesterol (LDL-C) from the blood 124.
Clinical trials have shown that Repatha can reduce LDL-C by about 50% to 60% from baseline when added to statin therapy in patients with high cholesterol or atherosclerotic cardiovascular disease (ASCVD) 12456. In patients with heterozygous familial hypercholesterolemia (HeFH) or ASCVD, LDL-C reductions ranged from 54% to 77% compared to placebo 24. For patients with HoFH, Repatha reduced LDL-C by about 30% compared to placebo 24.
Repatha also lowers other lipid parameters, including total cholesterol, non-HDL cholesterol, apolipoprotein B, and lipoprotein(a) 12. The efficacy of Repatha is maintained over the long term, and it is effective both as an add-on to statins and as monotherapy in statin-intolerant patients 127.
Clinical Benefits and Cardiovascular Outcomes
In addition to lowering cholesterol, Repatha has been shown to reduce the risk of major cardiovascular events. The FOURIER trial demonstrated a 15% reduction in major cardiovascular adverse events in patients with ASCVD and high cholesterol despite statin therapy . The benefit was closely linked to the degree of LDL-C reduction, even at very low LDL-C levels .
Safety and Tolerability
Repatha is generally well tolerated. The most common side effects include nasopharyngitis, upper respiratory tract infection, flu, back pain, and injection-site reactions such as redness, pain, or bruising. Allergic reactions like rash and hives have also been reported, but serious adverse events are rare 412. Studies have also shown that Repatha does not negatively affect cognitive function .
Indications for Use
Repatha is indicated for adults with primary hyperlipidemia (including HeFH and ASCVD) as an adjunct to diet and statin therapy, or for those who cannot tolerate statins. It is also approved for use in patients with HoFH who require additional LDL-C lowering 34.
Conclusion
Repatha (evolocumab) is a highly effective PCSK9 inhibitor for lowering LDL cholesterol, especially in patients who cannot reach their LDL-C goals with statins alone or who are statin-intolerant. The recommended dosage is 140 mg every two weeks or 420 mg once a month, with a strong safety profile and proven benefits in reducing cardiovascular events in high-risk patients 123456710.
Sources and full results
Most relevant research papers on this topic