For adults with heart disease who are already taking statins, adding evolocumab injections every two weeks or monthly lowers the risk of serious heart problems like heart attack, stroke, or...

Pro

Against

Mechanism

Synthesis from 1 study

How it works

Lowering bad cholesterol with this drug makes fatty buildups in arteries more stable and less likely to break open. When they don’t break open, blood clots are less likely to form and block arteries, which prevents heart attacks and strokes.

Most probable mechanism

In Simple Terms

By lowering the amount of bad cholesterol in the blood, the body reduces the buildup of fatty deposits inside artery walls. This makes the plaques less likely to rupture and trigger blood clots, which can block arteries and cause heart attacks or strokes.

Causal chain

PCSK9 inhibition increases the number of LDL receptors on liver cells, enhancing clearance of low-density lipoprotein cholesterol from the bloodstream

Verified by multiple studies

which leads to

Reduced circulating LDL cholesterol decreases lipid accumulation within atherosclerotic plaques in arterial walls

Verified by multiple studies

which leads to

Lower lipid content in plaques reduces macrophage activation and foam cell formation, decreasing plaque inflammation and necrotic core expansion

Verified by multiple studies

which leads to

Stabilized plaques with thinner fibrous caps and less inflammation are less prone to rupture

Verified by multiple studies

which leads to

Reduced plaque rupture lowers the incidence of thrombus formation, arterial occlusion, and subsequent ischemic events such as myocardial infarction, stroke, or unstable angina

Verified by multiple studies

Evidence from Studies

Supporting (1)

Community contributions welcome

Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial.

Randomized Controlled Trial

Human

Contradicting (0)

Community contributions welcome

No contradicting evidence found

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.

Source Study

Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial.

Score: 73

DOI: 10.1016/S2213-8587(17)30313-3

Similar Assertions

For people with heart disease who are already taking cholesterol-lowering pills, adding a drug called evolocumab can slash their bad cholesterol by about 60% in less than a year—bringing it down to very low levels.

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For people with heart disease who are already taking cholesterol-lowering drugs but still have high bad cholesterol, adding a drug called evolocumab can cut their risk of heart attack, stroke, or dying from heart problems by 20% over about two years.

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For people with heart disease who are already taking cholesterol-lowering drugs, adding a medicine called evolocumab can lower their chance of having a heart attack, stroke, or other serious heart problems by about 15% over two years.

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Even if your cholesterol is already pretty low thanks to statins, adding a drug called evolocumab can still help protect your heart and blood vessels.

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For people with heart disease who are on cholesterol-lowering drugs, adding a drug called evolocumab doesn’t raise their risk of serious side effects like diabetes or memory problems — the only real downside is a slightly higher chance of soreness at the injection site.

91%