Alirocumab reduced LDL-C levels by 57.1% at 24 weeks compared to a 6.3% increase with placebo in patients with hypercholesterolemia at high cardiovascular risk.
RCT
1:1
Yes
Does alirocumab reduce LDL-C levels in high cardiovascular risk patients with hypercholesterolemia on maximally tolerated statin?
Alirocumab significantly reduces LDL-C and other atherogenic lipoproteins in high-risk Asian patients on maximally tolerated statins, with a safety profile comparable to placebo.
Absolute Event Rate: -57.1% vs 6.3%
•ODYSSEY KT enrolled patients from South Korea and Taiwan.•ODYSSEY KT studied the efficacy and safety of alirocumab 75 up to 150 mg at 2-week intervals.•A pooled safety analysis was included from a broader patient population from Asia.•Alirocumab 75 up to 150 mg at 2-week intervals significantly reduced low-density lipoprotein cholesterol levels and other lipids.•Safety data were similar in ODYSSEY KT and the pooled analysis. BackgroundAlirocumab, a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9, has been shown to provide significant reductions in low-density lipoprotein cholesterol (LDL-C). Data about its efficacy and safety in patients from South Korea and Taiwan are limited.ObjectiveODYSSEY KT assessed the efficacy and safety of alirocumab in patients from South Korea and Taiwan.MethodsPatients with hypercholesterolemia at high cardiovascular risk who were on maximally tolerated statin were randomized (1:1) to alirocumab (75 mg every 2 weeks, with dose increase to 150 mg every 2 weeks at week 12 if LDL-C ≥70 mg/dL at week 8) or placebo for 24 weeks. The primary efficacy endpoint was percentage change in LDL-C from baseline to week 24. Safety was assessed throughout.ResultsAt week 24, alirocumab changed LDL-C levels by −57.1% (placebo: +6.3%). In the alirocumab group, 9 patients (9.5%) received dose increase at week 12. At week 24, 85.8% of patients in the alirocumab group reached LDL-C <70 mg/dL (placebo: 14.2%; P ≤ .0001 vs placebo). Alirocumab significantly improved non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B, total cholesterol, lipoprotein (a), and HDL-C vs placebo (P ≤ .05). Two consecutive calculated LDL-C values <25 mg/dL were recorded in 27.8% of alirocumab-treated patients. Overall, 58.8% (alirocumab) and 61.8% (placebo) of patients experienced treatment-emergent adverse events; 2.1% and 1.0% discontinued treatment due to treatment-emergent adverse events, respectively.ConclusionAlirocumab significantly improved LDL-C, apolipoprotein B, non-HDL-C, lipoprotein (a), HDL-C, and total cholesterol in Asian patients. Alirocumab was generally well tolerated. These findings are consistent with ODYSSEY findings to date. Alirocumab, a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9, has been shown to provide significant reductions in low-density lipoprotein cholesterol (LDL-C). Data about its efficacy and safety in patients from South Korea and Taiwan are limited. ODYSSEY KT assessed the efficacy and safety of alirocumab in patients from South Korea and Taiwan. Patients with hypercholesterolemia at high cardiovascular risk who were on maximally tolerated statin were randomized (1:1) to alirocumab (75 mg every 2 weeks, with dose increase to 150 mg every 2 weeks at week 12 if LDL-C ≥70 mg/dL at week 8) or placebo for 24 weeks. The primary efficacy endpoint was percentage change in LDL-C from baseline to week 24. Safety was assessed throughout. At week 24, alirocumab changed LDL-C levels by −57.1% (placebo: +6.3%). In the alirocumab group, 9 patients (9.5%) received dose increase at week 12. At week 24, 85.8% of patients in the alirocumab group reached LDL-C <70 mg/dL (placebo: 14.2%; P ≤ .0001 vs placebo). Alirocumab significantly improved non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B, total cholesterol, lipoprotein (a), and HDL-C vs placebo (P ≤ .05). Two consecutive calculated LDL-C values <25 mg/dL were recorded in 27.8% of alirocumab-treated patients. Overall, 58.8% (alirocumab) and 61.8% (placebo) of patients experienced treatment-emergent adverse events; 2.1% and 1.0% discontinued treatment due to treatment-emergent adverse events, respectively. Alirocumab significantly improved LDL-C, apolipoprotein B, non-HDL-C, lipoprotein (a), HDL-C, and total cholesterol in Asian patients. Alirocumab was generally well tolerated. These findings are consistent with ODYSSEY findings to date.
Koh et al. (Thu,) conducted a rct in Hypercholesterolemia at high cardiovascular risk. Alirocumab vs. Placebo was evaluated on Percentage change in LDL-C from baseline to week 24. Alirocumab reduced LDL-C levels by 57.1% at 24 weeks compared to a 6.3% increase with placebo in patients with hypercholesterolemia at high cardiovascular risk.