From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Repatha (evolocumab) is not known to commonly exacerbate angina, and in fact, may help reduce the overall risk of cardiovascular events in patients with established heart disease by lowering LDL cholesterol levels. According to the most recent and highest quality study, 1, evolocumab significantly reduced the risk of major adverse cardiovascular events, including hospitalization for unstable angina, in patients with atherosclerotic cardiovascular disease. The study found that evolocumab lowered LDL cholesterol levels by approximately 60% and reduced the risk of cardiovascular events by 15% compared to placebo.
Some key points to consider when prescribing Repatha to patients with angina include:
- The standard dosing of Repatha is either 140 mg every two weeks or 420 mg once monthly, administered as a subcutaneous injection.
- Patients with angina should continue their prescribed anti-anginal medications while using Repatha and maintain regular follow-ups with their cardiologist to monitor their cardiovascular status.
- The most common side effects of Repatha include injection site reactions, nasopharyngitis, and upper respiratory tract infections.
- If a patient experiences new or worsening chest pain while taking Repatha, they should seek immediate medical attention as this could be related to their underlying cardiovascular condition rather than the medication itself.
It's also worth noting that other studies, such as 2 and 3, have shown that evolocumab can improve cardiovascular outcomes and reduce the progression of coronary disease in statin-treated patients. However, the study by 1 is the most recent and highest quality study, and its findings should be given the most weight in clinical decision-making.