A SYSTEMATIC REVIEW OF EVOLOCUMAB FOR STROKE PREVENTION IN PATIENTS WITH DYSLIPIDEMIA

Introduction: Evolocumab is a human monoclonal immunoglobulin G2 (IgG2) directed against human proprotein convertase subtilisin/kexin type 9 (PCSK9). By inactivating PCSK9, evolocumab upregulates low-density lipoprotein receptor (LDLR) causing increased catabolism of low-density lipoprotein cholesterol (LDL-C) and the consequent reduction of LDL-C levels in the blood.

Objective: This systematic review aimed to identify the effectiveness of evolocumab for stroke prevention in patients with dyslipidemia.

Method: PubMed and Cochrane Library were searched to identify relevant studies. The keywords were the combination of the following words: evolocumab, PCSK9, stroke, and dyslipidemia. The inclusion criteria of the study i.e : patients with dyslipidemia, was a randomised controlled trial (RCT), published within ten (10) years (from 2008 to 2018), concerned on evolocumab and compared to other pharmacologic agents for the management of dyslipidemia or placebo. The quality of selected studies was assessed using Jadad score.

Results: There are only two studies matched with inclusion and exclusion criteria. The name of the trial was OSLER and FOURIER. Both studies used a subcutaneous injection of evolocumab with 2 types of dosage: 140 mg in every 2 weeks or 420 mg once in a month. OSLER was using standard dyslipidemia therapy, whereas FOURIER was using placebo as a control. Both studies were conducted for 12 months.

Conclusion: Subcutaneous injection of evolocumab is effective for the lowered LDL-C level. It is also effective for stroke prevention in patients with dyslipidemia.