The results of the recently published FOURIER trial have shown a reduction in cardiovascular events with addition of the PCSK9 inhibitor evolocumab (Repatha) to statin therapy in patients with atherosclerotic cardiovascular disease (ASCVD).
EVOLOCUMAB — Evolocumab is a human IgG2 monoclonal antibody injected subcutaneously every two weeks or once monthly. It targets PCSK9 (proprotein convertase subtilisin kexin type 9) and prevents it from binding to LDL receptors, resulting in increased LDL receptor expression and increased hepatic uptake of LDL-cholesterol (LDL-C). Like alirocumab (Praluent), the other FDA-approved PCSK9 inhibitor, evolocumab has been found to reduce LDL-C levels by about 55-60% when added to statin therapy, and it is generally well tolerated.1 Alirocumab has not yet been shown to improve cardiovascular outcomes.2
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The FDA has approved dupilumab (Dupixent – Sanofi/Regeneron), a subcutaneously-injected fully human monoclonal antibody, for treatment of adults with moderate to severe atopic dermatitis (eczema) that has not responded to topical therapies. It can be used with or without topical corticosteroids.
MECHANISM OF ACTION — Dupilumab binds to the IL-4 receptor alpha subunit shared by interleukin (IL)-4 and IL-13 receptors, inhibiting the signaling of these two cytokines, which are thought to be the drivers of atopic dermatitis, asthma, and possibly other ...