Evolocumab

Mechanism :

Evolocumab is a human monoclonal antibody (IgG2 isotype) that binds to proprotein convertase subtilisin kexin type 9 (PCSK9). PCSK9 binds to the low-density lipoprotein receptors (LDLR) on hepatocyte surfaces to promote LDLR degradation within the liver.

Indication :

Homozygous familial hypercholesterolemia
Primary hyperlipidemia (including heterozygous familial hyperlipidemia)

Contraindications :

Serious hypersensitivity to evolocumab or any component of the formulation.

Dosing :

Adolescents 13 to 17 years:

Homozygous familial hypercholesterolemia:

SC 420 mg once monthly.

Primary Hyperlipidemia:

SC 140 mg every 2 weeks or 420 mg once monthly.

Note: Use in combination with diet and other lipid-lowering therapies.

Adverse Effect :

Nasopharyngitis, hypertension, dizziness, fatigue, skin rash, gastroenteritis, UTI, influenza, injection site reaction, myalgia.

Interaction :

Belimumab: Monoclonal Antibodies may enhance the adverse/toxic effect of Belimumab.

Hepatic Dose :

Mild hepatic impairment: No dosage adjustment needed.
Moderate and severe hepatic impairment: Use not recommended