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Efficacy and Safety of Long-Term Evolocumab Use Among Asian Subjects　- A Subgroup Analysis of the Further

Anthony C Keech1, Kazuma Oyama2,3, Peter S Sever4

  • 1National Health and Medical Research Council Clinical Trials Centre, Sydney Medical School, University of Sydney.

Circulation Journal : Official Journal of the Japanese Circulation Society
|May 13, 2021
PubMed

Insights

Evolocumab effectively lowers LDL-C and reduces cardiovascular risks in Asian patients, demonstrating similar efficacy and safety compared to other populations in the FOURIER trial. This finding addresses concerns about differential drug responses.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacogenomics
  • Clinical Trials

Background:

  • Concerns exist regarding potential ethnic differences in medication response, particularly among Asian patients.
  • The FOURIER trial investigated the efficacy and safety of evolocumab in patients with atherosclerosis.

Purpose of the Study:

  • To evaluate the efficacy and safety of evolocumab in Asian versus non-Asian participants within the FOURIER trial.
  • To determine if evolocumab's lipid-lowering and cardiovascular benefits differ between racial groups.

Main Methods:

  • A post-hoc analysis of 27,564 stable atherosclerosis patients from the FOURIER trial (evolocumab vs. placebo).
  • Participants were categorized by self-reported race: Asian (n=2,723) and Other (n=24,841).
  • Primary endpoint: composite of cardiovascular death, myocardial infarction, stroke, unstable angina hospitalization, or coronary revascularization over a median of 2.2 years.

Main Results:

  • Asians had lower baseline LDL-C and were less likely to receive high-intensity statins compared to others.
  • Evolocumab achieved greater LDL-C reduction in Asians (66%) versus others (58%).
  • The cardiovascular benefit of evolocumab was consistent across racial groups (P interaction=0.55), with no increased serious adverse events in Asians.

Conclusions:

  • Evolocumab is effective in lowering LDL-C and reducing cardiovascular event risk in Asian patients.
  • The drug demonstrates comparable efficacy and safety in Asian individuals as observed in other populations.
  • Findings support the use of evolocumab across diverse ethnic groups for managing atherosclerotic disease.
Abstract

Keywords:
AsiansEvolocumabLDL cholesterolPCSK9 inhibitor

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