Alirocumab dosing patterns during 40 months of open-label treatment in patients with heterozygous familial hypercholesterolemia

• Published in: Journal of clinical lipidology 2018-11, Vol.12 (6), p.1463-1470
• Main Authors: Hovingh, G. Kees, Guyton, John R., Langslet, Gisle, Dufour, Robert, Baccara-Dinet, Marie T., Din-Bell, Chantal, Manvelian, Garen, Farnier, Michel
• Format: Article
• Language: English
• Subjects: Alirocumab; Dose adjustment; Familial hypercholesterolemia; LDL-C; Open-label extension; PCSK9
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2018.08.011

ODYSSEY OLE (NCT01954394) was an open-label extension (OLE) study for patients with heterozygous familial hypercholesterolemia (HeFH) who had completed previous phase 3 clinical trials with alirocumab. Alirocumab dose could be increased or decreased as per physician judgment. To assess how the alirocumab dosing strategy was used by physicians during OLE. Patients who entered OLE on a starting dose of alirocumab 75 mg every 2 weeks (Q2W) were included in the analysis (those from FH I, FH II, and LONG TERM trials). Those who completed LONG TERM entered an 8-week washout period before receiving alirocumab 75 mg Q2W at the start of OLE. From week 12, dose adjustment from 75 to 150 mg Q2W, or vice versa, was possible, based on the physician's clinical judgment. In total, 909 patients with HeFH completed the 3 parent studies and were treated during OLE for a duration of up to 40 months. Most patients (56.7%) were maintained on 75 mg Q2W throughout OLE, whereas 43.3% of patients had their dose increased to 150 mg Q2W. The dose was subsequently decreased in 7.4% of the patients in whom alirocumab was initially uptitrated. Overall, treatment-emergent adverse events were similar between those who had received placebo or alirocumab in the parent studies. In the opinion of physicians, alirocumab 75 mg Q2W enabled over half of patients with HeFH to achieve sufficient low-density lipoprotein cholesterol lowering. [Display omitted] •In total, 909 patients with heterozygous familial hypercholesterolemia received alirocumab (median duration 2.5 years).•Alirocumab dose received (75 or 150 milligrams) based on clinical judgment of physician.•Seventy-five milligram dose considered enough for low-density lipoprotein cholesterol control for 56.7% of patients by physicians.•During open-label extension, 5.9% of patients reported local injection-site reaction adverse events.•Physician's decision to increase alirocumab dose was primarily due to high low-density lipoprotein cholesterol.