How much does Repatha (evolocumab) lower LDL?
Repatha is a PCSK9 inhibitor that lowers LDL cholesterol substantially compared with placebo. Across clinical trials, it typically reduces LDL-C by about 50% to 60% when added to background therapy (such as statins), depending on the patient population and baseline LDL level.
How does the LDL drop compare versus statin alone?
When used on top of statins (and sometimes other lipid-lowering drugs), Repatha generally produces an additional LDL-C reduction around the 50–60% range versus baseline, translating to a much larger net LDL-C drop than statins alone. The exact percent can vary by study design, baseline LDL, and whether patients were already on high-intensity therapy.
What LDL reduction should patients expect in real-world terms?
Patients often see the largest LDL reductions after starting therapy, with effects showing up within weeks in clinical use. The percentage reduction is usually in the same ballpark as trials (about half to a bit more than half), but individual results vary—especially for people with different baseline LDL levels, adherence to background therapy, and concurrent medications.
Does the LDL reduction differ by condition (familial hypercholesterolemia vs. ASCVD)?
Yes. People with familial hypercholesterolemia and people with established atherosclerotic cardiovascular disease can have different baseline LDL levels and treatment histories, which affects the measured percent drop. The direction and magnitude of LDL lowering with Repatha remain large, but percent reductions can differ somewhat by subgroup.
What if someone is asking about the “best” percentage?
If you’re trying to compare numbers people mention online, it usually comes down to which trial and which comparator they’re using. The commonly cited range for Repatha LDL-C lowering in major studies is roughly 50%–60% on top of existing therapy.
Sources: None provided.