What are these drugs?
- Both Evolocumab and Alirocumab are monoclonal antibodies that inhibit an enzyme that down-regulates LDL receptors. This therefore increases the number of LDL receptors and so increases LDL uptake and reduces plasma LDL levels.
- They are given by subcutaneous injection.
- In most patients, they will be used in triple therapy with statins and ezetimibe. They can be used with just statins, or just with ezetimibe or other lipid lowering drugs. They can also be used alone.
When can they be used?
Evolocumab comes in 2 doses, but only the 140mg every 2 weeks dose is recommended (the higher dose is not cost-effective enough). Alirocumab comes in 75 or 150mg doses and both can be used.
They can be used when LDL levels are persistently above those specified below, despite maximum tolerated lipid-lowering therapy.