Prevention & lipidsSecondary analysis
Long-Term Lipid Lowering With Evolocumab in Older Individuals
- Secondary analysis of the FOURIER randomised trial and its open-label extension (FOURIER-OLE)
- age-stratified subgroup analysis
6,635 participants transitioned to open-label evolocumab (FOURIER-OLE), additional 5-year median follow-up
Authors' conclusion
Early initiation of long-term evolocumab provides older patients with atherosclerotic cardiovascular disease cardiovascular benefits at least as good as those observed in younger patients, with a more favorable number needed to treat in older patients for reducing a composite endpoint and no significant safety concerns.
Study context
- Population
- Patients aged 18–85 years with atherosclerotic CVD, analysed by age (<75 vs ≥75 years)2,526 (9%) aged ≥75
- Participants
- 27,564 patients
- Comparison
- Evolocumab vs placebo, by age <75 vs ≥75 years
- Primary endpoint
- CV death, MI, stroke, hospitalization for unstable angina or coronary revascularization
- Follow-up
- Median 7.1 years (FOURIER + FOURIER-OLE)
Primary result
As reported in the abstract
Primary endpoint by age · median 7.1 years
Evolocumab vs PlaceboHazard ratio (95% CI)
age ≥75 years
0.79(0.64–0.97)
age <75 years
0.86(0.80–0.92)
Evolocumab vs PlaceboAbsolute risk reduction (95% CI)
age ≥75 years; NNT 19
5.4%(−2.0% to 12.8%)
age <75 years; NNT 44
2.3%(0.1%–4.5%)
Safety
Annualized incidence of adverse events of interest
- Generally similar across treatment arms in both age groups
Original publication
Long-Term Lipid Lowering With Evolocumab in Older Individuals. J Am Coll Cardiol. Published 11 February 2025. doi:10.1016/j.jacc.2024.11.019
Summarised from the published abstract; every number is checked against it