Research article

Alirocumab and Coronary Atherosclerosis in Asymptomatic Patients with Familial Hypercholesterolemia: The ARCHITECT Study

CirculationPublished

  • Single-arm clinical trial
  • phase IV
  • open-label
  • multicentre

Authors' conclusion

Treatment with alirocumab in addition to high-intensity statin therapy resulted in significant regression of coronary plaque burden and plaque stabilization on coronary computed tomographic angiography over 78 weeks in these groups of patients with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease.

Study context

Population
Asymptomatic patients with familial hypercholesterolemia without clinical atherosclerotic CVD, on maximum tolerated statin dose with or without ezetimibe104 completed
Comparison
Alirocumab added to high-intensity statin therapy, 78 weeks vs baseline
Outcome
Change in coronary plaque burden and characteristics on coronary CT angiography
Follow-up
78 weeks

Main finding

As reported in the abstract

Coronary plaque burden

P < 0.001

Increase in calcified plaque proportion
+0.3%; P<0.001
Increase in mainly fibrous plaque proportion
+6.2%; P<0.001
Decrease in fibro-fatty plaque percentage
−3.9%; P<0.001
Decrease in necrotic plaque percentage
−0.6%; P<0.001

Further findings

LDL-C · 78 weeks

P < 0.001

Original publication

Alirocumab and Coronary Atherosclerosis in Asymptomatic Patients with Familial Hypercholesterolemia: The ARCHITECT Study. Circulation. Published 3 April 2023. doi:10.1161/circulationaha.122.062557

Summarised from the published abstract; every number is checked against it