Key result
Alirocumab reduces LDL-C by ~55% at 12 weeks in high-risk real-world patients.
Why the study?
Safety and efficacy data were needed for alirocumab in a real-life setting in high cardiovascular risk patients with HeFH or very-high LDL-C levels despite maximally tolerated statin ± other lipid-lowering therapies.
Does alirocumab reduce LDL-C and is it safe in high cardiovascular risk patients with HeFH or very-high LDL-C despite maximally tolerated statin therapy?
Does alirocumab reduce LDL-C and is it safe in high cardiovascular risk patients with HeFH or very-high LDL-C despite maximally tolerated statin therapy?
In a real-world setting, alirocumab was well tolerated and provided clinically significant LDL-C reductions in high cardiovascular risk patients with HeFH or very-high LDL-C.
Supports real-world LDL-C lowering by alirocumab in high-risk patients; leaves open randomized confirmation of safety and outcomes.
AIMS: To obtain safety and efficacy data of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, in a real-life setting in high cardiovascular (CV) risk patients with heterozygous familial hypercholesterolaemia (HeFH) or very-high low-density lipoprotein cholesterol (LDL-C) levels despite maximally tolerated dose of statin ± other lipid-lowering therapies (MTD ± LLTs). ODYSSEY APPRISE was a prospective, single-arm, Phase 3b open-label (≥12 weeks to ≤ 30 months) European/Canadian study with alirocumab. METHODS AND RESULTS: Patients received alirocumab 75 or 150 mg every 2 weeks, with dose adjustment based on physician's judgment. In total, 994 patients were enrolled and treated. The mean [standard deviation (SD)] duration of alirocumab exposure was 72.4 (42.5) weeks. Patients with HeFH were younger [mean (SD) age of 53.8 (11.6) vs. 61.6 (10.1) years], more likely to be female (41.7% vs. 29.1%) and had higher baseline LDL-C compared with non-familial hypercholesterolaemia (non-FH) patients [mean (SD) of 5.1 (1.7) vs. 4.1 (1.1) mmol/L]. The overall incidence of treatment-emergent adverse events (TEAEs) was 71.6%; common TEAEs included nasopharyngitis (7.8%), myalgia (7.1%), and headache (6.2%). At Week 12, mean (SD) LDL-C was reduced by 54.8 (20.1)% from baseline [2.6 (1.2) mmol/L], maintained for the trial duration. LDL-C was reduced below 1.8 mmol/L and/or by ≥50% reduction from baseline in 69.1% of patients overall, and for 64.7 and 77.4% of the HeFH and non-FH subgroups, respectively. CONCLUSION: In a real-life setting in patients with hypercholesterolaemia and high CV risk, alirocumab was generally well tolerated and resulted in clinically significant LDL-C reductions.
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Gaudet et al. (2020) studied Heterozygous familial hypercholesterolaemia or very-high LDL-C levels (n=994). Alirocumab was evaluated on LDL-C reduction from baseline at Week 12. In a real-life setting, alirocumab reduced LDL-C by a mean of 54.8% from baseline at 12 weeks in high cardiovascular risk patients, with an overall adverse event incidence of 71.6%.
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