Cholesterol drug Repatha reduces risk of heart attacks for $14K

Mar 21, 2017, 00:33
Cholesterol drug Repatha reduces risk of heart attacks for $14K

About 10% of patients taking the drug had a heart attack or stroke, or died of heart disease during the trial.

The first part of the story has already been proven - lots of trials in various groups have demonstrated powerful reductions in LDL cholesterol following treatment with anti-PCSK9 antibodies, with reductions of more than half routinely observed even among patients with stubbornly high cholesterol resistant to other lipid lowering medications.

"There has always been a debate that low LDL cholesterol levels could lead to negative effects on memory or other cognitive functions", saidRobert P. Giugliano, M.D., S.M., Brigham and Women's Hospital, Boston and lead study investigator.

PCSK9 drugs can reduce blood levels of cholesterol, which builds up in arteries (above), but only now have they been shown to prevent heart attacks and strokes.

The latest trial, involving 27,500 patients and led by Harvard Medical School and Imperial College London, provides that evidence.

"Why not just reduce the price of the drug and make it more broadly available?"
A quarter of the people on the new drug had LDL level 19, which meant that the drug proved to be effective.

Research showed a 27 percent decrease in the risk of heart attack, a 21 percent decrease in stroke, and a 22 percent decrease in the risk of cardiovascular revascularization. "It's remarkable to see such a large impact in reducing cardiac events given that this patient population was only on Repatha for about two years", stated Sean E. Harper, M.D., EVP of R&D at Amgen.

"As demand and use goes up, the insurance companies usually follow", Steinbaum said.

At the end of the treatment period, researchers found that on average, patients taking evolocumab plus statins were able to reduce their LDL cholesterol levels by an average of 59 per cent, from 92 mg/dL to 30 mg/dL, compared to those taking placebo plus statins.

Elevated levels of low-density lipoprotein (LDL) cholesterol can lead to cardiovascular disease and blood vessel blockage, leading to an increased risk heart attacks and stroke in patients. Most trial subjects had had a prior heart attack or stroke. Also, in some patients cholesterol levels can remain high despite being given the maximum doses of statins.

But they were approved only for those with a genetic condition that means they have dangerously high cholesterol, and people with heart disease who can not cope with the side effects of statins.

"It's a small reduction for a super expensive drug", said Dr. John Mandrola, a cardiologist at Baptist Health in Louisville, Ky., and chief cardiology correspondent for Medscape, who wasn't involved in the study. They then could wait up to six months before needing another shot.

"Our results suggest this new, extremely potent class of drug can cut cholesterol dramatically, which could provide great benefit for a lot of people at risk of heart disease and stroke", said Professor Peter Sever from Imperial College London, and the United Kingdom branch lead of the study, according to The New Daily.

Reacting to the offer, multiple doctors were mostly critical about the deal, stating that it may be a lose-lose situation for both the patient and their insurance provider.

Anti-PCSK9 antibodies are the jewel in the crown of modern genomic medicine, illustrating what many hope will be a paradigm for future drug discovery.

Amgen acknowledged during a presentation for investors that it is already selling Repatha at a discount, resulting in net prices between $US7,700 to $US11,200 per annual treatment, and believes those prices represent good value.