Literature DB >> 24691094

Anti-PCSK9 monotherapy for hypercholesterolemia: the MENDEL-2 randomized, controlled phase III clinical trial of evolocumab.

Michael J Koren1, Pernille Lundqvist2, Michael Bolognese3, Joel M Neutel4, Maria Laura Monsalvo5, Jingyuan Yang5, Jae B Kim5, Rob Scott5, Scott M Wasserman5, Harold Bays6.   

Abstract

OBJECTIVES: The aim of this study was to compare biweekly and monthly evolocumab with placebo and oral ezetimibe in patients with hypercholesterolemia in a phase III trial.
BACKGROUND: Evolocumab, a fully human monoclonal antibody against proprotein convertase subtilisin/kexin type 9 (PCSK9), significantly reduced LDL-C in phase II trials.
METHODS: Patients 18 to 80 years of age with fasting low-density lipoprotein cholesterol (LDL-C) ≥100 and <190 mg/dl and Framingham risk scores ≤10% were randomized (1:1:1:1:2:2) to oral placebo and subcutaneous (SC) placebo biweekly; oral placebo and SC placebo monthly; ezetimibe and SC placebo biweekly; ezetimibe and SC placebo monthly; oral placebo and evolocumab 140 mg biweekly; or oral placebo and evolocumab 420 mg monthly.
RESULTS: A total of 614 patients were randomized and administered doses. Evolocumab treatment reduced LDL-C from baseline, on average, by 55% to 57% more than placebo and 38% to 40% more than ezetimibe (p < 0.001 for all comparisons). Evolocumab treatment also favorably altered other lipoprotein levels. Treatment-emergent adverse events (AEs), muscle-related AEs, and laboratory abnormalities were comparable across treatment groups.
CONCLUSIONS: In the largest monotherapy trial using a PCSK9 inhibitor to date, evolocumab yielded significant LDL-C reductions compared with placebo or ezetimibe and was well tolerated in patients with hypercholesterolemia. (Monoclonal Antibody Against PCSK9 to Reduce Elevated LDL-C in Subjects Currently Not Receiving Drug Therapy for Easing Lipid Levels-2 [MENDEL-2]; NCT01763827).
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  PCSK9 inhibition; dyslipidemia; evolocumab; monotherapy

Mesh:

Substances:

Year:  2014        PMID: 24691094     DOI: 10.1016/j.jacc.2014.03.018

Source DB:  PubMed          Journal:  J Am Coll Cardiol        ISSN: 0735-1097            Impact factor:   24.094


  113 in total

Review 1.  PCSK9 in chronic kidney disease.

Authors:  P Pavlakou; E Liberopoulos; E Dounousi; M Elisaf
Journal:  Int Urol Nephrol       Date:  2017-01-13       Impact factor: 2.370

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Journal:  Drugs       Date:  2018-06       Impact factor: 9.546

Review 3.  Lipid lowering with PCSK9 inhibitors.

Authors:  Razvan T Dadu; Christie M Ballantyne
Journal:  Nat Rev Cardiol       Date:  2014-06-24       Impact factor: 32.419

Review 4.  Disorders of lipid metabolism in nephrotic syndrome: mechanisms and consequences.

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5.  Persistent arterial wall inflammation in patients with elevated lipoprotein(a) despite strong low-density lipoprotein cholesterol reduction by proprotein convertase subtilisin/kexin type 9 antibody treatment.

Authors:  Lotte C A Stiekema; Erik S G Stroes; Simone L Verweij; Helina Kassahun; Lisa Chen; Scott M Wasserman; Marc S Sabatine; Venkatesh Mani; Zahi A Fayad
Journal:  Eur Heart J       Date:  2019-09-01       Impact factor: 29.983

6.  PCSK9 inhibition-mediated reduction in Lp(a) with evolocumab: an analysis of 10 clinical trials and the LDL receptor's role.

Authors:  Frederick J Raal; Robert P Giugliano; Marc S Sabatine; Michael J Koren; Dirk Blom; Nabil G Seidah; Narimon Honarpour; Armando Lira; Allen Xue; Padmaja Chiruvolu; Simon Jackson; Mei Di; Matthew Peach; Ransi Somaratne; Scott M Wasserman; Rob Scott; Evan A Stein
Journal:  J Lipid Res       Date:  2016-04-21       Impact factor: 5.922

Review 7.  PCSK9 inhibitors for treating dyslipidemia in patients at different cardiovascular risk: a systematic review and a meta-analysis.

Authors:  Alessandro Squizzato; Matteo Basilio Suter; Marta Nerone; Robert Patrick Giugliano; Francesco Dentali; Andrea Maria Maresca; Leonardo Campiotti; Anna Maria Grandi; Luigina Guasti
Journal:  Intern Emerg Med       Date:  2017-07-10       Impact factor: 3.397

Review 8.  Evolocumab.

Authors: 
Journal:  Aust Prescr       Date:  2016-10-01

Review 9.  Vaccination against atherosclerosis.

Authors:  Kouji Kobiyama; Ryosuke Saigusa; Klaus Ley
Journal:  Curr Opin Immunol       Date:  2019-03-29       Impact factor: 7.486

Review 10.  Novel Therapies for Familial Hypercholesterolemia.

Authors:  Justin Parizo; Ashish Sarraju; Joshua W Knowles
Journal:  Curr Treat Options Cardiovasc Med       Date:  2016-11
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