Evinacumab Offers ‘Remarkable’ Lipid Lowering in Severe HoFH

Evinacumab (Regeneron) appears to have a dramatic effect on low-density lipoprotein (LDL) cholesterol levels in patients with homozygous familial hypercholesterolemia (HoFH) with little or no LDL receptor activity, suggests a post hoc analysis of phase 3 trial data.

The results, which one expert described as a “game changer” for these patients, were presented at the European Atherosclerosis Society 2020 Virtual Congress on October 5, held online this year because of the COVID-19 pandemic.

The phase 3 ELIPSE trial showed that evinacumab, a human monoclonal antibody inhibitor of angiopoietin-like 3 (ANGPTL3), given intravenously every 4 weeks reduced LDL cholesterol levels in HoFH patients by an average of 47%.

As reported by theheart.org | Medscape Cardiology, the treatment, which was generally well tolerated, was also effective in the approximately one third of patients with minimal residual LDL receptor activity.

Now, Frederick Raal, MD, PhD, the University of the Witwatersrand, Johannesburg, South

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Intensive Blood Pressure Lowering Potentially Harmful in ICH

Intensive lowering of systolic blood pressure (SBP) for patients with intracerebral hemorrhage (ICH) whose initial SBP is excessively high does not improve outcomes and is linked to safety concerns, new research shows.

Investigators found that ICH patients whose initial SBP was 220 mmHg and who underwent intensive BP lowering had twice the relative risk for neurologic deterioration at 24 hours without any reduction in hematoma expansion or 3-month risk for death and disability compared to their counterparts who underwent standard SBP lowering.

“The significantly higher rate of neurological deterioration associated with intensive treatment in patients with initial systolic blood pressure of 220 mm Hg or more warrants caution against broad recommendations for intensive systolic blood pressure reduction in patients with intracerebral hemorrhage,” the investigators, led by Iryna Lobanova, MD, Zeenat Qureshi Stroke Institute, University of Missouri, in Columbia, write.

The study was published online September 8 in JAMA Neurology.

Efficacy

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