Cholesterol-Lowering Treatment Repatha®▼ (Evolocumab) Offers New Way To Help UK Patients

CAMBRIDGE, England, September 1, 2015 /PRNewswire/ --

In people already using statins, new injection reduced "bad cholesterol" (low-density lipoprotein cholesterol, LDL-C) by between 55 and 75 per cent in clinical trials^[1] 

A new way to lower so-called "bad cholesterol" (LDL-C) is now available in the UK - the first in a new class of treatment to help people who are unable to get below guideline cholesterol levels using existing medicines and an appropriate diet. Using a fortnightly injection of Repatha^® (evolocumab) on top of statin treatment (80mg atorvastatin), patients in one clinical trial achieved an average LDL-C reduction that was 75% lower than those taking atorvastatin alongside a placebo (mean LDL-C, weeks 10-12)^[2]. It can also be taken on its own by people who are unable to take a statin^[1].

Evidence has shown that high cholesterol increases the risk of atherosclerosis, heart attack and stroke^[3]. Coronary Heart Disease (CHD), which leads to angina and heart attacks, remains the leading cause of death in the UK^[4].

Although a healthy diet and taking statins can be effective in reducing excessively high cholesterol (hypercholesterolaemia) to less risky levels, current options alone are unsuccessful for a significant number of people. Researchers have found that approximately 45 per cent of patients at high risk for cardiovascular disease (CVD) do not adequately lower their LDL-C levels with statins and/or other currently licensed lipid-lowering agents to achieve therapeutic goals^[5].

The science behind evolocumab is based on genetic insights into people who have especially high^[6], and especially low^[7], levels of a protein called PCSK9 - which inhibits the body's natural system for eliminating LDL-C from the blood. Evolocumab is a human monoclonal antibody that blocks PCSK9.

"Statins transformed our management of raised cholesterol and our understanding of this key risk factor for strokes and heart attacks," said Dr Terry McCormack, Principal in General Practice in Whitby, Secretary of the British Hypertension Society and evolocumab clinical trial investigator. "But our best efforts with statins - which remain the front line of therapy alongside low-fat diets, exercise and smoking cessation - still leave a significant number of patients with inadequately controlled cholesterol levels."

One condition linked to persistently raised cholesterol is familial hypercholesterolaemia (FH). It is one of the most common life-threatening genetic diseases^[8], affecting between 1 in 500 and 1 in 200 people (0.2 - 0.5 per cent)^[9],[10]. Those carrying FH genes experience persistently raised LDL-C. In a recent multi-centre study of almost 5,000 patients across Europe, possible FH (defined according to the UK Simon Broome criteria) was found in 5 per cent of people suffering a heart attack (Acute Coronary Syndromes, ACS) and 14 per cent of people having a heart attack at a young age.^[11] Even among patients attending specialist clinics, a national audit found that only 44 per cent of adult patients achieved the recommended target of 50 per cent reduction in LDL-C from the untreated level^[12] - as recommended in NICE guidelines.^[9] Treatment of FH patients is included in the recently published Summary of Product Characteristics (SmPC) for evolocumab^[1].

"Today's announcement will be welcomed by our high risk patients and their families," said Dr Dermot Neely, who runs the specialist Lipid Clinic at the Royal Victoria Infirmary (RVI) in Newcastle and is a HEART UK trustee^[13]. "It is over a decade since the last new drug class for cholesterol lowering therapy was introduced in the UK. We now have a new treatment option which may be considered in patients who are resistant to statins or unable to take them. In particular, our patients with severe forms of FH frequently have persistently raised cholesterol levels and remain at serious risk of having a heart attack or stroke, despite a healthy diet, healthy lifestyle and currently available lipid-lowering treatments in maximum combinations."

In clinical studies^[1], LDL-C reductions of 55 to 75 per cent were achieved versus placebo as early as the first week of treatment and maintained during long-term therapy. Based on either a 140mg self-administered injection every 2 weeks, or 3 such injections (420mg) once a month, evolocumab demonstrated a reduction in LDL-C of more than half in 80 to 85 per cent of patients.

Across studies of more than 6,000 patients with raised LDL-C, the most commonly reported adverse reactions were nasopharyngitis (4.8 per cent), upper respiratory tract infection (URTI, 3.2 per cent), back pain (3.1 per cent), influenza (2.3 per cent), arthralgia (2.2 per cent) and nausea (2.1 per cent).

John Kearney, General Manager, Amgen UK & Ireland, said: "We deeply appreciate the commitment of the patients and health professionals who have participated in clinical trials in the UK and made today's announcement possible. We will now work eagerly with all our partners and stakeholders in the NHS to see how this medicine can begin to help UK patients."

The effect of evolocumab on cardiovascular morbidity and mortality has not yet been determined^[1]. An ongoing study, FOURIER, is exploring the extent to which the LDL-C reductions achieved by evolocumab treatment may prevent future cardiovascular events such as heart attacks and strokes. From a total of 27,564 patients enrolled globally in the trial there are 1,490 in the UK; spread across 79 trial centres nationwide. The study results are expected in 2017.

Amgen is working with the National Institute for Health and Care Excellence (NICE) in its review of the use of evolocumab for the treatment of primary hypercholesterolaemia and mixed dyslipidaemia. This NICE review is in progress and is expected to publish guidance for the NHS on use of evolocumab in April 2016.

Notes For Editors 

About Amgen 

Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology.

Amgen focuses on areas of high unmet medical need and leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be one of the world's leading independent biotechnology companies, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential.

For more information, visit http://www.amgen.co.uk.

About evolocumab 

For more information on the safety profile and efficacy of evolocumab, please refer to the Summary of Product Characteristics.^[1]

About Amgen Cardiovascular 

Building on more than three decades of experience in developing biotechnology medicines for patients with serious illnesses, Amgen is dedicated to addressing important scientific questions to advance care and improve the lives of patients with cardiovascular disease. Amgen's research into cardiovascular disease, and potential treatment options, is part of a growing competency at Amgen that utilizes human genetics to identify and validate certain drug targets. Through its own research and development efforts, as well as partnerships, Amgen is building a cardiovascular portfolio in an effort to address a number of today's important unmet patient needs, such as high cholesterol and heart failure.

References 

1. Repatha^® (evolocumab) Summary of Product Characteristics. Online Here.
2. Robinson JG, et al. JAMA. 2014;311:1870-82.
3. NHS Choices - High Cholesterol. Online Here.
4. NHS Choices - Coronary Heart Disease. Online Here.
5. Waters DD, et al. Circulation. 2009;120:28-34.
6. Abifadel, M. Nature Genetics 2003.34;2.
7. Cohen JC et al. N Engl J Med 2006; 354:1264-1272
8. Goldberg AC, et al. J Clin Lipid. 2011;5:S1-S8.
9. NICE Clinical Guideline 71. Identification and management of familial hypercholesterolaemia. August 2008. Online Here.
10. Nordestgaard BG, et al. Eur Heart J. 2013;34:3478-90
11. Nanchen D et al. European Heart Journal 2015. Online publication 4 July, 2015.
12. Pedersen KMV et al. National Clinical Audit of the Management of Familial Hypercholesterolaemia 2010: Full Report. Clinical Standards Department, Royal College of Physicians, December 2010.
13. Heart UK - the cholesterol charity. More information Online Here.

CONTACT:    
James Read, Amgen, UK & Ireland
Phone: +44(0)7585-404909
Email: james.read@amgen.com

Laura Chambers, Just Health Communications
Phone: +44(0)7793-049657
Email: laura@justhealthcomms.com