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Angiopoietin-like 3 (ANGPLT3) affects lipid metabolism via inhibition of lipoprotein lipase and endothelial lipase. People with loss-of-function mutations in ANGPLT3 have reduced levels of LDL cholesterol, HDL cholesterol, and triglycerides and an elevated risk for coronary disease. Evinacumab, a fully human monoclonal antibody directed against ANGPLT3, has been shown to significantly lower LDL-c in preclinical studies but is not yet FDA-approved. In an industry-supported, multinational phase II trial (NCT03175367), investigators assessed the clinical efficacy of evinacumab in 272 patients with refractory hypercholesterolemia (LDL-c ≥70 mg/dL with atherosclerosis or ≥100 mg/dL without atherosclerosis despite maximally tolerated lipid treatm…