Abstract 14506: Effect of Evolocumab on Lipoprotein Profiles in Patients With and Without Diabetes
Introduction: Evolocumab, a monoclonal antibody against PCSK9, reduces low-density lipoprotein cholesterol (LDL-C) and improves other lipid levels. In this post hoc analysis, we examined the effect of evolocumab on lipoprotein particle concentrations assessed by nuclear magnetic resonance (NMR) spectroscopy in patients with and without diabetes.
Methods: In the 52-week placebo-controlled Durable Effect of PCSK9 Antibody Compared with Placebo Study (DESCARTES), patients with hyperlipidemia were assigned based on CV risk to background lipid-lowering therapy (diet, atorvastatin [ATV] 10 mg/day, ATV 80 mg/day, or ATV 80 mg/day plus ezetimibe 10 mg/day), and then randomized 1:2 to placebo or evolocumab 420 mg monthly. Data were available from stored samples for 530 patients; samples were evaluated for LDL, HDL, IDL, and chylomicron/VLDL particle concentrations.
Results: See Table. Baseline characteristics were generally balanced between the evolocumab and placebo groups. Evolocumab therapy led to a significant decrease in LDL particle concentration and a significant increase in HDL particle concentration in diabetic and non-diabetic patients. IDL and VLDL/chylomicron particle concentrations decreased significantly with evolocumab in all patients and in the subgroup without diabetes; the diabetes subgroup showed similar trends, but these did not reach statistical significance, likely due to the smaller sample size.
Conclusions: Evolocumab therapy resulted in improvements in atherogenic lipoprotein particle concentrations, including a decrease in LDL, IDL, and VLDL/chylomicron concentrations, and an increase in HDL-P concentrations in patients with and without diabetes.
Author Disclosures: H. Soran: Research Grant; Significant; Amgen, Synageva, Alexion, Pfizer, MSD. Honoraria; Modest; Genzyme-Sanofi, MSD, Synageva. Other; Modest; Aegerion, Amgen, AstraZeneca, Eli Lilly, Fresenius, Janssen Cilag Ltd., MSD, Pfizer. P.P. Toth: Speakers Bureau; Modest; Kowa, Novartis, Sanofi-Aventis. Consultant/Advisory Board; Modest; Merck, Regeneron, Sanofi-Aventis. Speakers Bureau; Significant; Amarin, Amgen, Merck, Regeneron. Consultant/Advisory Board; Significant; Amgen, Kowa, Regeneron, Merck. N. Sattar: Research Grant; Modest; Amgen, Astra Zeneca. Consultant/Advisory Board; Modest; Amgen, Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Merck, Sanofi. D.J. Blom: Research Grant; Modest; Amgen, Sanofi-Aventis, AstraZeneca, Ionis, Eli Lilly. Honoraria; Modest; Amgen, Aegerion, AstraZeneca, Pfizer, Sanofi. Consultant/Advisory Board; Modest; Amgen, Aegerion, Sanofi-Aventis. S.S. Martin: Honoraria; Modest; Abbott Nutrition, American College of Cardiology, Pew Research Center, Quest Diagnostics, Sanofi-Regeneron. S.R. Jones: None. M. Banach: Speakers Bureau; Modest; Abbott/Mylan, Abbott Vascular, Actavis, Akcea, Amgen, KRKA, MSD, Sanofi-Aventis. Consultant/Advisory Board; Modest; Abbott Vascular, Amgen, Daichii Sankyo, Esperion, MSD, Resverlogix, Sanofi-Aventis. M. Monsalvo: Employment; Significant; Amgen Inc. M. Elliott: Employment; Significant; Amgen Inc. M. Davis: Employment; Significant; Amgen Inc. R. Somaratne: Employment; Significant; Amgen Inc. D. Preiss: Consultant/Advisory Board; Modest; Sanofi.
- © 2016 by American Heart Association, Inc.