Highlights
- •Dose optimization of evinacumab may be used to reduce drug expenses.
- •An average 34% dose reduction might be possible without compromising efficacy.
- •This strategy may facilitate access to treatment of evinacumab by reducing costs.
Background
Evinacumab is a first-in-class inhibitor of angiopoietin‐like protein 3 (ANGPTL3)
for treatment of the rare disease homozygous familial hypercholesterolemia (HoFH).
With projected drug costs of $450,000 per person per year, the question rises if cost-efficacy
of evinacumab can be further improved.
Objectives
To develop an individualized dosing regimen te reduce drug expenses.
Methods
Using the clinical and pharmacological data as provided by the license holder, we
developed an alternative dosing regimen in silico based on the principles of reduction of wastage by dosing based on weight bands rather
than a linear milligram per kilogram body weight (mg/kg) dosing regimen, as well as
dose individualization guided by low density lipoprotein cholesterol (LDL-C) response.
Results
We found that the average quantity of drug used for a dose could be reduced by 34%
without predicted loss in efficacy (LDL-C reduction 24 weeks after treatment initiation).
Conclusion
Dose reductions without compromising efficacy seem feasible. We call for implementation
and prospective evaluation of this strategy to reduce treatment costs of HoFH.
Keywords
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Article info
Publication history
Published online: March 14, 2023
Accepted:
March 7,
2023
Received:
November 28,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 National Lipid Association. Published by Elsevier Inc.
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