What does repatha do

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Understanding the Role of Repatha (Evolocumab) in Hypercholesterolemia Treatment

Introduction to Repatha (Evolocumab)

Repatha, also known by its generic name evolocumab, is a fully human monoclonal antibody developed by Amgen. It has been approved for the treatment of hypercholesterolemia, particularly in patients who do not achieve sufficient LDL-C reduction with statins and other lipid-lowering therapies 124.

Mechanism of Action: PCSK9 Inhibition

Targeting PCSK9

Evolocumab works by targeting and inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9), a protein that regulates the degradation of low-density lipoprotein receptors (LDL-R) on the liver cells. By inhibiting PCSK9, evolocumab increases the number of LDL receptors available to clear LDL cholesterol (LDL-C) from the bloodstream, thereby significantly lowering LDL-C levels 125.

Administration and Dosage

Repatha is administered via subcutaneous injection, with common dosages being 140 mg every two weeks or 420 mg once a month 26. This flexibility in dosing helps accommodate patient preferences and treatment plans.

Clinical Efficacy and Safety

LDL-C Reduction

Clinical trials have demonstrated that evolocumab can reduce LDL-C levels by approximately 50-60% when used in combination with statins or as monotherapy in statin-intolerant patients 236. This reduction is significant compared to placebo and other lipid-lowering agents like ezetimibe .

Long-term Efficacy and Safety

Long-term studies have shown that the efficacy of evolocumab in lowering LDL-C is maintained over time, and it is generally well-tolerated by patients 25. The FOURIER trial highlighted that evolocumab not only reduces LDL-C levels but also decreases the incidence of major cardiovascular events by 15% in patients with atherosclerotic cardiovascular disease .

Indications and Usage

Primary Hypercholesterolemia and Mixed Dyslipidemia

Repatha is indicated for adults with primary hypercholesterolemia (both heterozygous familial and non-familial) or mixed dyslipidemia as an adjunct to diet and other lipid-lowering therapies 14.

Homozygous Familial Hypercholesterolemia

It is also approved for use in patients aged 12 years and older with homozygous familial hypercholesterolemia, a condition characterized by extremely high levels of LDL-C that are difficult to manage with conventional therapies alone 14.

Statin-Intolerant Patients

For patients who are intolerant to statins, evolocumab offers a viable alternative to achieve LDL-C reduction and manage hypercholesterolemia effectively 26.

Conclusion

Repatha (evolocumab) represents a significant advancement in the treatment of hypercholesterolemia, particularly for patients who are unable to achieve their LDL-C targets with statins and other lipid-lowering therapies. By inhibiting PCSK9, Repatha effectively lowers LDL-C levels and reduces the risk of cardiovascular events, making it a valuable option in the management of high cholesterol 125.

Sources and full results

Most relevant research papers on this topic

Evolocumab: First Global Approval

Evolocumab has been approved as a treatment for hypercholesterolaemia in the EU, and is awaiting approval in the USA and Japan, for adults with primary hypercholesterolaemia or mixed dyslipidaemia.

2015·

19citations

·A. Markham

Evolocumab: A Review in Hyperlipidemia

Evolocumab is a valuable new treatment for primary hypercholesterolemia, mixed dyslipidemia, and homozygous familial hypercholesterolemia, particularly in patients unable to reach LDL-C goals despite statins and those who cannot tolerate or receive statins.

Very Rigorous Journal

2016·

14citations

·G. Keating

Evolocumab (Repatha)--a second PCSK9 inhibitor to lower LDL-Cholesterol.

Evolocumab (Repatha) is a second PCSK9 inhibitor that can lower LDL-cholesterol levels by 60% in high-risk patients already taking maximal statin therapy, but long-term efficacy and safety are unknown and expensive.

2015·

4citations

Evolocumab (Repatha)--A Second PCSK9 Inhibitor to Lower LDL-Cholesterol.

Evolocumab is an injectable PCSK9 inhibitor that lowers LDL-cholesterol in adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease, and is approved as an adjunct to diet and maximally tolerated statin therapy for patients with homozyg

2015·

6citations

[Evolocumab (Repatha®) : new therapy ofhypercholesterolaemia for secondary prevention of atherosclerotic disease].

Evolocumab (Repatha®) effectively reduces cardiovascular events and is now reimbursed for secondary prevention of atherosclerotic cardiovascular disease in patients with residual hypercholesterolaemia despite statin therapy.

2023·

0citations

·A. Scheen et al.

[Evolocumab (Repatha®) : a human monoclonal antibody against PCSK9 protein as potent cholesterol-lowering therapy].

Evolocumab effectively reduces LDL-C levels by 50-60% when added to statins, and is a promising treatment for patients with heterozygous and homozygous familial hypercholesterolemia.

2017·

1citation

·C. Wallemacq

Clinical study of Repatha: it does not affect patients’ cognitive function and significantly reduce blood lipid and prevent coronary atherosclerosis

Repatha effectively reduces blood lipids and prevents coronary atherosclerosis in patients with hyperlipidemia, without affecting cognitive function.

2022·

0citations

·Yongzhe Li

Pharmaceutical Approval Update.

Evolocumab for hypercholesterolemia, trifluridine/tipiracil for metastatic colorectal cancer, and Nuwiq for hemophilia A have been approved by the FDA.

2015·

0citations

·Kunj Gohil

Purification and characterization of RepA, a protein involved in the copy number control of plasmid pLS1.

RepA protein plays a role in plasmid pLS1 copy number control by limiting the synthesis of the initiator protein RepB.

1989·

46citations

·G. Solar et al.

Statement for Appropriate Clinical Use of PCSK9 Inhibitors

PCSK9 inhibitors are a powerful option for patients with insufficient LDL-C management, but their use should be limited to those who truly need them and benefit greatly from their use.

Very Rigorous Journal

2018·

5citations

·A. Nohara et al.

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