Background: Evolocumab is a potent lipid-lowering drug that decreases plasma levels of lowdensity
lipoprotein cholesterol (LDL-C) by 50-60%. FOURIER is a landmark randomized trial involving
27,564 patients with established cardiovascular disease already on statins and plasma LDLC
levels > 70 mg/dl.
Objective: The main objective of FOURIER was to examine the effects of evolocumab on cardiovascular
Results: After a mean follow-up of 2.2 years, evolocumab significantly decreased the primary endpoint
(composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable
angina, or coronary revascularization) by 15% compared to placebo [hazard ratio 0.85 (95% CI,
0.79-0.92)], but no significant effect was found on mortality. The most common adverse effect of
evolocumab was mild injection site reaction occurring in 2.1% of patients versus 1.6% of patients
Conclusion: These results support the use of evolocumab as add-on therapy to statins for high cardiac-
risk patients not achieving optimal goals of LDL-C. Longer-term studies are needed to further
clarify the efficacy and safety of evolocumab.