Evolocumab is a new injectable drug that can further lower cholesterol levels in people taking statin drugs by inhibiting PCSK9, a protein that reduces the liver's ability to remove LDL cholesterol from the bloodstream. It works by binding to PCSK9 as a human monoclonal antibody, preventing PCSK9 from binding to LDL receptors on the liver surface and allowing more LDL receptors to remove LDL-C from the blood. Evolocumab shows promise for treating people with genetic high cholesterol or those unable to take high statin doses, but it is expected to be an expensive drug if approved by the FDA. Further studies are underway to evaluate its long-term safety and outcomes.

1. Dr. P.Naina Mohamed
Pharmacologist
New Drug to Lower ‘LDL'
Cholesterol - Evolocumab

2. Introduction
 According to the results of a global trial, a new
injectable drug (Evolocumab) can further knock
down cholesterol levels in people who take
cholesterol-busting statin medications.
 The lead author of the trial said that this drug
enhances the body's natural way of reducing LDL
levels in the bloodstream.
 Evolocumab is a "human monoclonal antibody" which
inhibits Proprotein Convertase Subtilisin/Kexin type 9
(PCSK9).
 PCSK9 is produced by liver and is a regulatory
protein which targets LDL receptors for degradation
and thereby reduces the liver's ability to remove LDL-

3. Possible Mechanism of
Action
Evolocumab (Human monoclonal antibody)
Monoclonal antibodies bind to PCSK9
Inhibition of binding of PCSK9 with LDL
receptors on the liver surface
Increased number of LDL receptors
Removal of LDL-C from the
blood

4. Conclusion
 Evolocumab will be mostly helpful in treating people
with a genetic disorder that causes them to have high
cholesterol.
 It also could help people with high cholesterol who
can't take large doses of statins.
 An expert said a follow-up study is underway to
evaluate Evolocumab's longer-term outcomes and
safety. But if it does gain U.S. Food and Drug
Administration approval, the drug will be expensive.
 Evolocumab is a very specific antibody, it seems to be
very well-tolerated without any drug interactions or
any side effects.

5. References
 http://jama.jamanetwork.com/article.aspx?articleid
=1869210
 http://www.nlm.nih.gov/medlineplus/news/fullstory
_146222.html
 http://www.nejm.org/doi/full/10.1056/NEJMoa131
6222
 http://www.cardiosource.org/News-
Media/Publications/Cardiology-
Magazine/2014/03/Evolocumab.aspx