New Drug Update – Repatha (Evolocumab)
Update on Repatha (Evolocumab) – a Medication Used to Treat High Low Density Lipoprotein Cholesterol
Approved by the FDA in August 2015, Repatha (Evolocumab) is a subcutaneous injection used to treat high LDL (low density lipoprotein) cholesterol in patients who have not been able to adequately lower LDL levels with current treatment options.
Repatha is classified as a PCSK9 (proprotein convertase subtilisin kexin 9) inhibitor and is approved for use as an adjunct treatment for adult patients receiving maximally tolerated statin therapy or who are unable to tolerate statins diagnosed with heterozygous or homozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease.
Repatha targets PCSK9, a protein that decreases the number of receptors on the liver responsible for removing LDL cholesterol from the bloodstream. Repatha prevents PCSK9 from blocking these receptors, increasing the number of receptors available to remove LDL cholesterol from the bloodstream, resulting in a decrease in LDL levels. Clinical trials have shown an average decrease of LDL levels by 60 percent as compared to placebo.
Repatha is administered as a subcutaneous injection, given as 140mg every 2 weeks or 420mg every month. It is available in either a prefilled syringe or an autoclick injector. The medication should be stored in the refrigerator and should be left out to warm to room temperature for at least 30 minutes prior to injection. Repatha can be stored at room temperature for up to 30 days. If not used within 30 days at room temperature, the medication must be discarded. The needle cover of the prefilled syringes and the autoclick injector may contain latex. Use with caution in patients with a latex allergy.
Common side effects include nasopharyngitis, upper respiratory infection, influenza, back pain and injection site reactions. No dosage adjustment is required for patients with mild to moderate renal or hepatic impairment. Rash and hives have occurred during treatment with Repatha. If symptoms of a serious allergic reaction occurs, the medication should be discontinued.
References: 1. FDA approves Repatha to treat certain patients with high cholesterol; http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm460082.htm; Accessed 5/12/2016. 2. Prescribing information Repatha injection http://pi.amgen.com/united_states/repatha/repatha_pi_hcp_english.pd; accessed 5/12/2016
This article was originally published in our monthly issue of From the Front Lines – a monthly publication that shares best practices and medication-related challenges faced by “front line” staff in long-term care and post-acute (LTCPAC) facilities.