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Evolocumab Does Not Impact Cognition in Atherosclerotic CVD

Adding evolocumab to maximally tolerated statin therapy did not affect patient-reported cognition

MONDAY, May 4, 2020 (HealthDay News) — For patients with atherosclerotic cardiovascular disease and low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL or non-high-density cholesterol ≥100 mg/dL despite statin therapy, evolocumab has no impact on patient-reported cognitive function, according to a study published in the May 12 issue of the Journal of the American College of Cardiology.

Baris Gencer, M.D., from Harvard Medical School in Boston, and colleagues studied self-reported cognition in the Further Cardiovascular Outcomes Research With PCSK9 inhibitors in Subjects With Elevated Risk (FOURIER) trial. Patients completed a 23-item survey on memory and executive domains from the Everyday Cognition (ECog) scale at the final visit.

At a median duration of 2.2 years, 22,655 patients completed ECog. The researchers found that the proportion of patients reporting cognitive decline (ECog score ≥2) was similar for placebo versus evolocumab at the end of the study for total score (3.6 versus 3.7 percent) and for subdomains (memory: 5.8 versus 6.0 percent; total executive, 3.6 versus 3.7 percent). Among the 2,338 patients who achieved very low LDL-C levels (<20 mg/dL) and the 3,613 with LDL-C ≥100 mg/dL, the proportion of patients reporting a decline in total cognitive score was similar (3.8 versus 4.5 percent).

“These data confirm the neurocognitive safety of intensive LDL-C reduction with evolocumab while reducing recurrent cardiovascular events in high-risk patients, and suggest that very low achieved LDL-C levels may be safely targeted for high-risk patients,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Amgen, which manufactures evolocumab and funded the study.

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