Background The main goal in the therapy of lipids disorders is to prevent morbidity associated with cardiovascular mortality. Evolocumab is a new drug appropiate in reducing the cholesterol level in hypercholesterolaemia and mixed dyslipidaemia.
Purpose To describe the efficacy and safety of evolocumab in patients who are affected by hypercholesterolaemia and mixed dyslipidaemia.
Material and methods Retrospective observational study in which the efficacy and safety of evolocumab was tested by means of revising the medical and pharmaceutical records of all patients who received evolocumab during 2016 and until May 2017. These dispensations were obtained through the register in the Athos APD Prisma program. To test efficacy we measured the percentage of cholesterol reduction LDL(C-LDL) 12 weeks after the start of this therapy. This data were obtained by revising the results of the laboratory analysis. To test security we revised the adverse events derived from evolocumab seen in the medical records of the patients.
Results All 30 patients (22 males, eight females) received evolocumab: 30% diagnosed with familial hypercholesterolaemia and 70% with mixed dyslipidaemia. Eighty-six per cent were or had been treated with statins, 20% with fibrates and 83% with ezetimibe. Thirty-six per cent were statin-intolerant. Dosage of evolocumab was 140 mg/15 days. The average percentage reduction in C-LDL in the 12th week was 63%. Evolocumab therapy was stopped due to ineffectiveness in one patient only. Concerning safety, 13% of patients had adverse affects, these were: myalgia, arthralgia, diarrhoea and gingival bleeding, each of them with the same incidence rate (3%). Only one patient needed to stop therapy because of myalgia. Two patients (6%) discontinued therapy with evolocumab due to very low levels of C-LDL.
Conclusion Evolocumab is an effective drug in reducing C-LDL level, however further studies are needed to demonstrate the reduction in mortality in patients with high cardiovascular risk. Evolocumab showed a good safety and tolerability profile.
No conflict of interest