Drugs like alirocumab and evolocumab can lower bad cholesterol by more than half in people with a genetic cholesterol problem, and they keep working well for over a year with regular use.
Evidence from Studies
No evidence studies found yet.
What Would Prove This
Per GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this claim, ordered from strongest to weakest.
Definitively quantify the average LDL-C reduction and cardiovascular event reduction across all high-quality trials.
A systematic review and meta-analysis of ≥20 randomized controlled trials involving ≥50,000 patients with HeFH or ASCVD, comparing PCSK9 inhibitors vs placebo or standard care, reporting LDL-C change at 52 weeks and major adverse cardiovascular events (MACE) over ≥3 years, with subgroup analysis by baseline statin use and inhibitor type.
Establish causal effects of PCSK9 inhibitors on LDL-C and cardiovascular outcomes.
A double-blind, placebo-controlled RCT of 10,000 patients with HeFH or established ASCVD, randomized to evolocumab 140 mg every 2 weeks vs placebo for 3 years, with primary endpoints of percent change in LDL-C at 12 weeks and time to first MACE, powered to detect 15% relative risk reduction.
Assess real-world effectiveness and long-term safety in diverse populations.
A prospective cohort study of 20,000 patients prescribed PCSK9 inhibitors in routine care, matched 1:1 with controls on statins alone, followed for 5 years to evaluate LDL-C trajectories, MACE incidence, and adverse events including neurocognitive effects and diabetes risk.
Estimate current prevalence of LDL-C goal attainment among users.
A national cross-sectional survey of 5,000 adults with ASCVD or HeFH currently on lipid-lowering therapy, measuring actual LDL-C levels, medication use, and demographic factors to assess proportion achieving <70 mg/dL.