Evolocumab safety and efficacy in hypercholesterolemia patients with or without diabetes: a retrospective real-world analysis

• DOI: 10.1186/s13098-025-01587-x
• Publication Date: 2025-01-31T05:53:28Z
• Authors: Sultan Ibrahim Al...; Hind Almodaimegh; Abdullah Kharbosh; Hadeel Alharbi; Ahmed Ibrahim Fat...; Mona Yaser Alsheikh; Lama Alfehaid
• Keywords: Evolocumab

Proprotein convertase subtilisin/kexin type 9 inhibitors effectively reduce LDL cholesterol and adverse cardiovascular events with a safety profile comparable to placebo. Limited real-world data exists on their effectiveness in different patient groups. This study evaluated evolocumab's efficacy hypercholesteremia patients without diabetes. In large tertiary hospital Saudi Arabia, aged 18 above who initiated evolocumab therapy were screened for eligibility between January 2017 July 2023. All had been maximally tolerated statin ezetimibe at least 4 months before starting included. The included participants then divided into diabetic non-diabetic groups assessed safety. Efficacy was measured by LDL-C reduction target achievement, while examining glycemic control changes, new-onset diabetes (NOD) hepatic enzyme levels. Data analysis descriptive comparative methods, significance set p < 0.05. A total of 151 included, an average age 51.77 years. majority male (67.6%) obese (81.5%). Around 55% diabetes, 63% established atherosclerotic disease baseline. During mean follow-up period 13.17 months, the from baseline - 34.21, 28.66, 39.61% overall cohort, patients, respectively. 34.4 24.5% reached levels less than 1.4 mmol/L (55 mg/dL) 1.8 (70 mg/dL), Worsening (HbA1C increase > 0.5) observed 25.83% 16.18% non-diabetics, 33.74% diabetics. An HbA1C 1 13.25% 2.94% non-diabetics 21.69% Five (3.3%) developed NOD. demonstrated that addition reduced but smaller lower proportion achieving recommended targets landmark clinical trials. Additionally, there potential negative effect control, warranting further investigation.