Safety and efficacy of alirocumab in a real-life setting: the ODYSSEY APPRISE study. (30th November 2020)

• Record Type: Journal Article
• Authors: Gaudet, Daniel; López-Sendón, José Luis; Averna, Maurizio; Bigot, Grégory; Banach, Maciej; Letierce, Alexia; Loy, Megan; Samuel, Rita; Manvelian, Garen; Batsu, Isabela; Henry, Patrick
• Is Part Of: European journal of preventive cardiology. Volume 28:Number 17(2021)
• Page Start: 1864
• Page End: 1872
• Publication Date: 2020-11-30
• Subjects: AlirocumabProprotein covertase subtilisin/kexin type 9 -- Familial hypercholesterolaemia -- LDL cholesterol; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1093/eurjpc/zwaa097
• Languages: English
• ISSNs: 2047-4873

Abstract

Abstract: Aims: To obtain safety and efficacy data of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, in a real-life setting in high cardiovascular (CV) risk patients with heterozygous familial hypercholesterolaemia (HeFH) or very-high low-density lipoprotein cholesterol (LDL-C) levels despite maximally tolerated dose of statin ± other lipid-lowering therapies (MTD ± LLTs). ODYSSEY APPRISE was a prospective, single-arm, Phase 3b open-label (≥12 weeks to ≤ 30 months) European/Canadian study with alirocumab. Methods and results: Patients received alirocumab 75 or 150 mg every 2 weeks, with dose adjustment based on physician's judgment. In total, 994 patients were enrolled and treated. The mean [standard deviation (SD)] duration of alirocumab exposure was 72.4 (42.5) weeks. Patients with HeFH were younger [mean (SD) age of 53.8 (11.6) vs. 61.6 (10.1) years], more likely to be female (41.7% vs. 29.1%) and had higher baseline LDL-C compared with non-familial hypercholesterolaemia (non-FH) patients [mean (SD) of 5.1 (1.7) vs. 4.1 (1.1) mmol/L]. The overall incidence of treatment-emergent adverse events (TEAEs) was 71.6%; common TEAEs included nasopharyngitis (7.8%), myalgia (7.1%), and headache (6.2%). At Week 12, mean (SD) LDL-C was reduced by 54.8 (20.1)% from baseline [2.6 (1.2) mmol/L], maintained for the trial duration. LDL-C was reduced below 1.8 mmol/L and/or by ≥50% reduction from baseline in 69.1% of patients overall, and for 64.7 and 77.4% of the HeFH and non-FH subgroups, respectively. Conclusion: In a real-life setting in patients with hypercholesterolaemia and high CV risk, alirocumab was generally well tolerated and resulted in clinically significant LDL-C reductions.