Effects of evinacumab on high-density lipoprotein function in patients with homozygous familial hypercholesterolemia

The effects of evinacumab on high-density lipoprotein (HDL) function remains unclear.

We aimed to clarify the effects of evinacumab on HDL function.

Serum cholesterol uptake capacity (CUC) levels, which represent HDL function were determined using our original cell-free assay before and after the introduction of evinacumab in patients with genetically diagnosed homozygous familial hypercholesterolemia (HoFH) (N = 5, mean age = 54 years, male = 2).

Significant reductions were observed in median low-density lipoprotein (LDL) cholesterol level by evinacumab (152 mg/dL to 88 mg/dL, 242.1%, p = 0.008), while the median HDL cholesterol level was unchanged (37 mg/dL to 30 mg/dL, -23.3%, p = 0.29). We found significant increase of the median CUC level (122 to 149 arbitrary units [A.U.], +22.1%, p = 0.03). The percent change of CUC was positively correlated with that of HDL cholesterol (Pearson's R² = 0.07471), while there was no correlation between that of CUC and LDL cholesterol (Pearson's R² = 0.0007).

HDL function assessed by serum CUC level increased by evinacumab in patients with genetically diagnosed HoFH, although the change of CUC was correlated with that of HDL cholesterol level.