FOURIER analysis: PCSK9 inhibition helps MetS patients the most

Given the relatively high cost for the PCSK9 inhibitor drugs, clinicians need to know which patients are likely to get the biggest bang for the buck from these agents. This will be not just patients with the highest risks for cardiovascular disease events, but those with modifiable risk factors.

The finding of greater benefit from evolocumab in patients with metabolic syndrome seen in this new analysis of data from FOURIER is consistent with other reported analyses from this trial, which identified other markers of greater benefit such as peripheral artery disease, recent MIs, and multivessel coronary artery disease. The next step will be to try to put all these findings together and figure out which patients get the most benefit from treatment. If society can’t afford to treat all eligible patients with expensive PCSK9 inhibitors, we need to learn how to use these drugs in the most cost-effective way.

Stephen J. Nicholls, MD , is professor of cardiology at the University of Adelaide, Australia. He has received research funding from and has been a consultant to several drug companies including Amgen and Sanofi/Regeneron, the companies that market PCSK9 inhibitors. He made these comments in an interview.