Intensive Lowering of LDL Cholesterol Levels With Evolocumab in Autoimmune or Inflammatory Diseases: An Analysis of the FOURIER Trial
Authors' conclusion
Intensive lowering of low-density lipoprotein cholesterol levels with evolocumab may lead to greater relative reduction in cardiovascular events in patients with an AIID.
Study context
- Population
- Patients with stable atherosclerosis taking statins, with or without an autoimmune or inflammatory disease (AIID)889 (3.2%) with AIID
- Participants
- 27,564 patients
- Comparison
- Evolocumab vs placebo, by presence of AIID
- Primary endpoint
- Composite of:
- CV death
- MI
- Stroke
- Unstable angina
- Coronary revascularization
Methodological detailssubgroup analysis
- Subgroup analysis
Primary result
As reported in the abstract
Primary end point, by AIID (subgroups)
Evolocumab vs PlaceboHazard ratio (95% CI)
Without AIID (14% reduction)
0.86(0.80–0.93)
With AIID (42% reduction)
0.58(0.38–0.89)
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Key secondary end point (CV death, MI or stroke), by AIIDEvolocumab vs Placebo · without AIID (19% reduction) | 0.81 (0.74–0.89) | |
| Key secondary end point (CV death, MI or stroke), by AIIDEvolocumab vs Placebo · with AIID (58% reduction) | 0.42 (0.24–0.74) | |
| 0.20.5125Hazard ratio (log scale) |
Baseline LDL-C, AIID vs no AIID
P = 0.025
Placebo-adjusted % LDL-C reduction with evolocumab
P = 0.57
Baseline hsCRP
P < 0.001
- Key secondary end point (CV death, MI or stroke), by AIID: interaction P=0.022
Baseline hsCRP
- hsCRP did not significantly change with evolocumab in either group
Original publication
Intensive Lowering of LDL Cholesterol Levels With Evolocumab in Autoimmune or Inflammatory Diseases: An Analysis of the FOURIER Trial. Circulation. Published 21 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it