View source for Evolocumab

{{MedTemplate
| generic           = Evolocumab
| brand             = Repatha
| structure         =
| classes           = [[:Category:PCSK9_inhibitors|PCSK9 inhibitor]], [[:Category:Lipid-lowering_agents|Lipid-lowering agent]], [[:Category:Biologics|Biologic]], [[:Category:Monoclonal_antibodies|Monoclonal antibody (fully human IgG2)]]
| uses              = <vote slug="hyperlipidemia-statin-refractory-use">Hyperlipidemia not at LDL goal on maximally-tolerated statin ± ezetimibe</vote>, <vote slug="hofh-use">Homozygous familial hypercholesterolemia</vote>, <vote slug="ascvd-secondary-prevention-use">Established ASCVD with elevated LDL despite statin (FOURIER trial)</vote>
| starting_dose     = 140 mg SC every 2 weeks OR 420 mg SC monthly (3 consecutive injections 5 minutes apart due to volume)
| preparations      = 140 mg/mL single-use prefilled syringe and SureClick autoinjector; Pushtronex 420 mg/3.5 mL on-body infusor
| fda_max           = 420 mg/month
| pill_id           =
| routes            = Subcutaneous
| onset             = LDL reduction ~50-60% from baseline at 1-2 weeks
| duration          = 2-4 weeks per dose
| halflife          = ~11-17 days<ref name="repatha-label">FDA Prescribing Information, Repatha (evolocumab), Amgen, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/125522s014lbl.pdf</ref>
| bioavailability   = ~72% from SC depot<ref name="repatha-label" />
| pregnancy         = Limited data.{{citation needed}}
| legal             = [[USLegal:Prescription only|Rx-only]] in US
| mechanism         = <vote slug="evolocumab-mech-claim">Evolocumab is a fully human IgG2 monoclonal antibody against proprotein convertase subtilisin/kexin type 9 (PCSK9); PCSK9 normally binds the LDL receptor and targets it for lysosomal degradation, so blocking PCSK9 increases hepatic LDL receptor density, accelerates LDL clearance, and lowers serum LDL by ~50-60% on top of statin therapy.</vote> The FOURIER trial (2017) established cardiovascular event reduction on top of statin therapy, with no apparent floor below which further LDL reduction stopped helping. Cost (~$5,000/year US) and SC injection burden have limited uptake compared with statins<ref name="repatha-label" />.
}}

== References ==
<references />
[[Category:PCSK9 inhibitors]]
[[Category:Lipid-lowering agents]]
[[Category:Biologics]]
[[Category:Monoclonal antibodies]]