Does Evolocumab Decrease CV Events in At-Risk Patients with Autoimmune or Inflammatory Disease?

Autoimmune and inflammatory diseases (AIIDs) increase cardiovascular (CV) disease risk. To assess the effectiveness of the subcutaneous PCSK9 inhibitor evolocumab in lowering that risk, researchers analyzed data from the manufacturer-sponsored FOURIER trial, which enrolled some 27,500 patients with stable cardiovascular disease and low-density lipoprotein (LDL) ≥70 mg/dL who were on statin therapy (NEJM JW Cardiol Mar 17 2017 and N Engl J Med 2017; 376:1713). Approximately 900 patients (3%) had AIID (mostly rheumatoid or psoriasis); they were older (median age, 65 vs. 63 years), more likely to be women (37% vs. 24%), and less likely to be current smokers (22% vs. 28%) than patients without AIID. Baseline median LDL was approximately 90 mg/d…