RE:RE:INTERESTING REPORT FROM ACC PRESENTATION ON evolocumab :
JK,
1. Yes. LDL can be brought down too low. LDL is a primary lipid/ cholesterol transporter to cells. Unmodified LDL is not bad. What is bad is modified (acetylated or oxidized LDL). This modification occurs primarily within the arterial wall and is a major culprit for destabilization of vulnerable plaques. Too little LDL and cells don't get enough cholesterol which they need for many functions including division. How low is too low depends largely on the method of inhibiting LDL. This therapy will largely be targeted at those who are intolerant or refractory to statins so their LDL will already be very high.
2. Yes, this is what the statin data is based on. Additionally the theory goes that one way to reduce oxLDL within the arterial wall is to reduce plasma levels of normal LDL.
3. Most are by injection including amgens but there are some that can be given orally but they are much further behnd in development. The injectables look to be a once or twice a month dosing.