Does Inflammation Alter the Effectiveness of PCSK9 Inhibitors?

Now that two trials of PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors have had positive results, interest will grow regarding the targeting of these expensive agents. To investigate whether baseline inflammatory risk modified the effect of evolocumab, researchers reanalyzed data from FOURIER, a manufacturer-funded, randomized, double-blind, placebo-controlled trial (NEJM JW Cardiol May 2017 and N Engl J Med 2017; 376:1713) that enrolled people with atherosclerotic cardiovascular disease who were taking statins. The primary rationale for the reanalysis was that high-sensitivity C-reactive protein (hsCRP) is associated with cardiovascular risk.

There were 27,495 participants with measured hsCRP (levels: <1 mg/L, 29% of partic…