In adults with diabetes who do not have advanced artery disease, the drug evolocumab lowers the chance of having a heart attack, stroke, or needing a procedure to restore blood flow over five years,...
Mechanism
Synthesis from 1 study
This drug stops a protein from removing LDL receptors from the liver, so the liver can pull more bad cholesterol out of the blood. With less cholesterol building up in artery walls, blockages that cause heart attacks or the need for artery-opening procedures become much less likely.
Most probable mechanism
A drug blocks a protein that normally removes LDL receptors from the liver, so more receptors stay on the liver surface to pull LDL cholesterol out of the blood. With less LDL in the blood, less fat builds up in artery walls, which stops small plaques from forming and growing. This reduces the chance that blood flow gets blocked, preventing heart attacks, strokes, or the need for procedures to open blocked arteries.
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 membrane instead of being destroyed 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 slows initiation and progression of atherosclerotic lesions in arterial walls
Stabilization of nascent plaques and reduced plaque burden lowers the likelihood of thrombotic occlusion
Decreased thrombotic occlusion reduces the incidence of ischemia-driven cardiovascular events, including revascularization procedures
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)
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Gold Standard Evidence Needed
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