Factorial Effects of Evolocumab and Atorvastatin on Lipoprotein Metabolism
Authors' conclusion
In healthy, normolipidemic subjects, evolocumab decreased the concentration of atherogenic lipoproteins, particularly LDL, by accelerating their catabolism. Reductions in intermediate-density lipoprotein and LDL production also contributed to the decrease in LDL particle concentration with evolocumab by a mechanism distinct from that of atorvastatin.
Study context
- Population
- Healthy, normolipidemic, nonobese men
- Participants
- 81 participants
- Comparison
- Evolocumab and atorvastatin, alone and combined, on apoB kinetics
- Primary endpoint
- Plasma kinetics of VLDL-, IDL- and LDL-apoB (stable isotope D3-leucine tracer, multicompartmental modeling)
- Follow-up
- 8 weeks
Methodological details2-by-2 factorial
- 2-by-2 factorial
Primary result
As reported in the abstract
apoB kinetics
- Atorvastatin accelerated fractional catabolism of very-low-density lipoprotein (VLDL)-apoB
- P<0.001
- Evolocumab accelerated fractional catabolism of VLDL-apoB
- P.032
- Atorvastatin accelerated fractional catabolism of IDL-apoB
- P=0.021
- Evolocumab accelerated fractional catabolism of IDL-apoB
- P=.002
- Both interventions accelerated fractional catabolism of low-density lipoprotein (LDL)-apoB
- P<0.001
- Evolocumab but not atorvastatin decreased production rate of IDL-apoB
- P=0.043
- Evolocumab but not atorvastatin decreased production rate of LDL-apoB
- P<0.001
Further findings
LDL-apoB and LDL-C concentration reduction
- Reduction significantly greater with combination vs either monotherapy
- P < 0.001
Free PCSK9, lathosterol/campesterol ratio, apoC-III, apoE, lipoprotein lipase, CETP mass, insulin resistance
- Evolocumab but not atorvastatin lowered free PCSK9
- Atorvastatin lowered lathosterol/campesterol ratio and apoC-III
- Both decreased plasma apoE
- Neither significantly altered lipoprotein lipase, cholesteryl ester protein mass or insulin resistance measures
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Factorial Effects of Evolocumab and Atorvastatin on Lipoprotein Metabolism. Circulation. Published 9 December 2016. doi:10.
Summarised from the published abstract; every number is checked against it