Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Clinical Pharmadynamics of Evolocumab

Clin Pharmacokinet; ePub 2018 Jan 20; Kasichayanula, et al

The pharmacodynamic effects of PCSK9 inhibitor evolocumab are rapid, with maximum suppression within 4 hours, according to a recent review of the clinical pharmacokinetics and pharmacodynamics. The review also found:

  • Evolocumab exhibits nonlinear kinetics and a half-life of 11 to 17 days.
  • With maximal suppression of PCSK9 occurring within 4 hours, peak reduction of LDL-C, ranging from 55 to 75%, occurs ~1-2 weeks after a dose of evolocumab.
  • Patient-specific factors do not have a clinically meaningful effect on the pharmacodynamic effects of evolocumab; thus, no dose adjustment is necessary based on patient-specific factors of concomitant medication use.
  • When combined with a statin, evolocumab can result in additional lowering of LDL-C.

Kasichayanula S, Grover A, Emery MG, et al. Clinical pharmacokinetics and pharmacodynamics of evolocumab, a PCSK9 inhibitor. [Published online ahead of print January 20, 2018]. Clin Pharmacokinet. doi:10.1007/s40262-017-0620-7.

This Week's Must Reads

Detection & Management of Resistant Hypertension, Hypertension; ePub 2018 Sep 13; Carey, et al

Does Aspirin Prevent CV Events in Older Adults?, N Engl J Med; ePub 2018 Sep 16; McNeil, et al

Timing of ICD Placement From Last Hospitalization for HF, Circulation; ePub 2018 Sep 13; Ambrosy, et al

FFR and Quality of Life After PCI, Circulation; ePub 2018 Sep 18; Nishi, et al

VTE risk for continuous cycle oral contraceptives, Li J et al. JAMA Intern Med. 2018 Oct 1. doi:10.1001/jamainternmed.2018.4251

Must Reads in Hypercholesterolemia

Racial Differences in Statin Use, JAMA Cardiol; ePub 2018 Jun 13; Nanna, et al

LLT Use in Patients with Elevated LDL-C, Circ Cardiovasc Qual Outcomes; ePub 2018 May 10; Virani, et al

Evolocumab in Differing Patient Populations , J Pharmacokinet Pharmacodyn; ePub 2018 May 7; Kuchimanchi, et al

LDL-C Targets in Elderly Statin Users After ACS, J Am Heart Assoc; ePub 2018 May 12; Alter, et al

Patient Perspectives on Statin Therapy, Clin Cardiol; ePub 2018 May 10; Brinton