Efficacy and safety of long-term evolocumab use among Asian subjects : A Subgroup analysis of the further cardiovascular outcomes research with PCSK9 inhibition in subjects with elevated risk (FOURIER) Trial -

Keech, Anthony C. and Oyama, Kazuma and Sever, Peter S. and Tang, Minao and Murphy, Sabina A. and Hirayama, Atsushi and Lu, Chen and Tay, Leslie and Deedwania, Prakash C. and Siu, Chung-Wah and Pineda, Armando Lira and Choi, Donghoon and Charng, Min-Ji and Amerena, John and Ahmad, Wan Azman Wan and Chopra, Vijay K. and Pedersen, Terje R. and Giugliano, Robert P. and Sabatine, Marc S. and Grp, FOURIER Study (2021) Efficacy and safety of long-term evolocumab use among Asian subjects : A Subgroup analysis of the further cardiovascular outcomes research with PCSK9 inhibition in subjects with elevated risk (FOURIER) Trial -. Circulation Journal, 85 (11). 2063+. ISSN 1346-9843, DOI https://doi.org/10.1253/circj.CJ-20-1051.

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Abstract

Background: There are concerns that Asian patients respond differently to some medications. This study evaluated the efficacy and safety of evolocumab among Asian vs. other subjects in the FOURIER trial, which randomized stable atherosclerosis patients to receive either evolocumab or placebo. Methods and Results: Effects of adding evolocumab vs. placebo to background statin therapy on low-density lipoprotein cholesterol (LDL-C) reductions, cardiovascular outcomes, and adverse events were compared among 27,564 participants with atherosclerotic disease, according to self-reported Asian (n=2,723) vs. other (n=24,841) races followed for a median of 2.2 years in the FOURIER trial. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. At randomization, Asians had slightly lower LDL-C (median 89 IQR 78-104] mg/dL vs. 92 80-109] mg/dL; P<0.001) and were much less likely to be on a high-intensity statin (33.3% vs. 73.3%; P<0.001). Evolocumab lowered LDL-C more in Asians than in others (66% vs. 58%; P<0.001). The effect of evolocumab on the primary endpoint was similar in Asians (HR, 0.79; 95% CI, 0.61-1.03) and others (HR, 0.86; 95% CI, 0.79-0.93; P interaction=0.55). There was no excess of serious adverse events with evolocumab among Asians over others. Conclusions: Use of evolocumab robustly lowers LDL-C and is equally efficacious in lowering the risk of cardiovascular events and safe in Asians as it is in others.

Item Type: Article
Funders: Amgen
Uncontrolled Keywords: Asians;Evolocumab;LDL cholesterol;PCSK9 inhibitor
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 30 May 2022 08:12
Last Modified: 30 May 2022 08:12
URI: http://eprints.um.edu.my/id/eprint/34620

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