For adults with diabetes who have not yet developed severe artery disease, adding the drug evolocumab every two weeks to their existing statin treatment lowers the chance of having a heart attack,...
Mechanism
Synthesis from 1 study
By blocking a protein that destroys cholesterol cleaners in the liver, the treatment lets the liver remove more bad cholesterol from the blood. This stops cholesterol from building up in artery walls early on, preventing the first heart attack, stroke, or death from heart disease in people with...
Most probable mechanism
A special protein blocks another protein that normally destroys cholesterol-clearing receptors in the liver. With more receptors available, the liver pulls more bad cholesterol out of the blood. This keeps cholesterol from building up in artery walls, which stops new blockages from forming and prevents heart attacks, strokes, or death from heart disease.
A monoclonal antibody binds to and neutralizes PCSK9 protein in circulation
Neutralized PCSK9 cannot bind to LDL receptors on hepatocytes, preventing receptor degradation
LDL receptors are recycled to the hepatocyte cell surface instead of being broken down in lysosomes
Increased LDL receptor density on hepatocytes enhances clearance of LDL particles from plasma
Sustained reduction in plasma LDL cholesterol decreases lipid deposition into the arterial intima
Reduced lipid accumulation in arterial walls inhibits the formation and progression of early atherosclerotic lesions
Stabilization of nascent plaques and reduced plaque burden lowers the likelihood of thrombotic occlusion leading to myocardial infarction, ischemic stroke, or cardiovascular death
Evidence from Studies
Supporting (1)
Community contributions welcome
Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes
Contradicting (0)
Community contributions welcome
Gold Standard Evidence Needed
According to GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this specific claim, ordered from strongest to weakest evidence.