Evolocumab Shows Sustained Cardiovascular Benefits in Older Patients With ASCVD: FOURIER Trial Findings
USA: A recent study has highlighted the long-term benefits of evolocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, in older individuals with atherosclerotic cardiovascular disease (ASCVD).
The findings, published in the Journal of the American College of Cardiology, suggest that early initiation of evolocumab provides significant lipid-lowering effects and cardiovascular protection comparable to those observed in younger patients. Notably, older patients demonstrated a more favorable number needed to treat (NNT) to reduce major cardiovascular events, reinforcing the potential of this therapy in high-risk populations.
Uncertainty regarding the effectiveness and safety of intensive low-density lipoprotein cholesterol (LDL-C) reduction in older patients has led to more conservative recommendations for individuals aged 75 and above in U.S. guidelines. At the same time, ASCVD remains a major cause of morbidity and mortality worldwide, with older adults being particularly vulnerable to adverse outcomes. While lipid-lowering therapies such as statins and ezetimibe are commonly used, PCSK9 inhibitors like evolocumab provide a potent additional option for reducing LDL-C levels. However, limited data exist on the long-term benefits of PCSK9 inhibition in this age group, highlighting the need for further research.
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