For adults with diabetes who do not have advanced artery disease, adding evolocumab every two weeks to their maximum statin dose lowers the chance of having a first heart attack, stroke, or dying...

We analyzed three assertions about evolocumab in adults with diabetes, and all support the idea that adding this drug to statin therapy may lower the chance of heart attack, stroke, or needing a procedure to restore blood flow over five years. None of the evidence we reviewed contradicts this. The evidence we’ve reviewed suggests that for adults with diabetes who haven’t developed advanced artery disease, taking evolocumab every two weeks — alongside their maximum statin dose — is linked to a reduced risk of these cardiovascular events compared to taking a placebo. This pattern held across all three assertions we examined, each based on data from studies tracking outcomes over five years. The drug appears to offer additional protection beyond what statins alone provide, particularly in preventing first-time events like heart attacks or strokes. We did not find any studies in our review that showed evolocumab had no benefit or increased risk in this group. However, the evidence we’ve reviewed only covers people without advanced artery disease, so we can’t say whether the same effect applies to those with more severe blockages. Also, while the outcomes measured — heart attack, stroke, and need for blood flow procedures — are important, we don’t have data here on long-term side effects, cost, or how this compares to other newer treatments. What this means for someone with diabetes: if you’re already on a high-dose statin and haven’t had major artery problems, adding evolocumab might help lower your risk of future heart or blood vessel events. But whether it’s right for you depends on your full health picture, and this decision should be made with your doctor.