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Evolocumab (Repatha)--a second PCSK9 inhibitor to lower LDL-Cholesterol.

The second FDA-approved PCSK9 inhibitor evolocumab (Repatha) appears to be similar in efficacy and safety to alirocumab (Praluent), but no comparative studies are available. Given by subcutaneous injection every 2 weeks or once monthly, evolocumab can further lower LDL-cholesterol levels by about 60% in patients at high risk for atherosclerotic cardiovascular disease already taking maximal statin therapy. Its effect on cardiovascular outcomes remains to be established. The long-term efficacy and safety of both evolocumab and alirocumab are unknown, and they are expensive.