Repatha indication
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Indications for Repatha (Evolocumab)
Treatment of Hypercholesterolemia
Repatha (evolocumab) is primarily indicated for the treatment of hypercholesterolemia. It is a fully human monoclonal antibody that targets proprotein convertase subtilisin/kexin type 9 (PCSK9), a protein that negatively regulates low-density lipoprotein (LDL) receptors. By inhibiting PCSK9, Repatha enhances the liver's ability to remove LDL cholesterol (LDL-C) from the blood, thereby significantly reducing LDL-C levels .
Primary Hypercholesterolemia
Repatha is approved for use in adults with primary hypercholesterolemia, including both heterozygous familial hypercholesterolemia (HeFH) and non-familial forms. It can be used as monotherapy or in combination with statins and other lipid-lowering therapies . Clinical trials have demonstrated that evolocumab effectively reduces LDL-C levels by 50-60% when added to statin therapy .
Homozygous Familial Hypercholesterolemia
In addition to primary hypercholesterolemia, Repatha is also indicated for patients with homozygous familial hypercholesterolemia (HoFH). For these patients, Repatha is used in combination with other lipid-lowering therapies to achieve further reductions in LDL-C levels .
Secondary Prevention of Atherosclerotic Cardiovascular Disease
Repatha has shown significant benefits in the secondary prevention of atherosclerotic cardiovascular disease. The FOURIER trial demonstrated that evolocumab significantly reduces the incidence of major cardiovascular events in patients with atherosclerotic cardiovascular disease who have residual hypercholesterolemia despite statin therapy. This has led to its approval for secondary prevention under specific conditions.
Statin-Intolerant Patients
Repatha is also a valuable option for patients who are intolerant to statins. It has been shown to effectively lower LDL-C levels in statin-intolerant patients when used as monotherapy . This makes it a crucial alternative for those who cannot tolerate or are contraindicated for statin therapy.
Administration and Dosage
Repatha is administered via subcutaneous injection, with recommended dosages of 140 mg every two weeks or 420 mg once monthly . This flexible dosing schedule allows for tailored treatment plans based on patient needs and preferences.
Conclusion
Repatha (evolocumab) is a potent PCSK9 inhibitor with multiple indications for the treatment of hypercholesterolemia, including primary hypercholesterolemia, homozygous familial hypercholesterolemia, and as an adjunct therapy for secondary prevention of atherosclerotic cardiovascular disease. It is particularly beneficial for patients who are unable to achieve LDL-C targets with statins alone or who are statin-intolerant. The efficacy and safety of Repatha have been well-documented in numerous clinical trials, making it a valuable addition to lipid-lowering treatment options.
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