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Alirocumab (Praluent) — PCSK9-inhibitor monoclonal antibody
A fully human monoclonal-antibody PCSK9 inhibitor (Praluent), injected under the skin every 2 weeks, that lowers LDL cholesterol by ~50–60%. In the ODYSSEY OUTCOMES trial of ~18,900 post-heart-attack patients it reduced major cardiovascular events and showed a possible all-cause mortality signal. Generally well tolerated; injection-site reactions and high cost/access are the main trade-offs. Prescription drug, not a supplement.
Prescription medication — not a dietary supplement
Alirocumab (Praluent) is a prescription (or investigational) drug, not a supplement. It is included here for reference because people research and discuss it (often used off-label) — not as a recommendation. Take it only under a qualified clinician's supervision and only as prescribed; do not source it from grey-market vendors, where identity, purity, and dosing are unverified. The evidence below reflects its clinical trials.
What the evidence says
Alirocumab (Praluent) doesn't have enough studies with structured effect-size data yet to pool a verdict. Browse the studies below for individual findings.
Most evidence is from high-quality meta-analyses and randomised trials published 2012–2026 with a typical study size of 206 participants.
Based on 244 studies · 62 meta-analyses · 131 RCTs · 206 total participants
Confidence
High confidenceBy outcome
Alirocumab has strong randomized human-outcome evidence: ODYSSEY OUTCOMES (~18,900 post-ACS patients) showed reduced major cardiovascular events and a possible all-cause mortality signal, on top of consistent ~50–60% LDL-C lowering across LONG TERM and familial-hypercholesterolemia trials and supporting meta-analyses. The score reflects genuinely strong cardiovascular evidence balanced against practical trade-offs — a subcutaneous injection with injection-site reactions, and high cost/access barriers — for a prescription drug presented as informational, not a recommendation.
139 randomised trials
90% were about Alirocumab (Praluent) in an audit of 50 of them
Every randomised or controlled trial of Alirocumab (Praluent) indexed in PubMed, not a hand-picked subset. Meta-analyses and systematic reviews are deliberately excluded from this count: most of them cover many compounds at once, so counting them would inflate it.
PubMed · as of Sep 2026
26 trials ongoing or recruiting · 69 completed on ClinicalTrials.gov
39 of the completed trials have posted results
Registered trials show research momentum for Alirocumab (Praluent), not proof of effect — a registration is a plan, and posted results are sponsor-reported, not peer-reviewed. They are never counted toward the evidence rating above.
Browse these trials on ClinicalTrials.govClinicalTrials.gov · as of Nov 2026
Alirocumab is a fully human monoclonal antibody that inhibits PCSK9 (proprotein convertase subtilisin/kexin type 9).
PCSK9 normally binds the LDL receptor on liver cells and marks it for degradation; by blocking PCSK9, alirocumab spares LDL receptors so they keep recycling to the cell surface and clearing LDL cholesterol from the blood.
The result is a large LDL-C reduction — roughly 50–60% on top of statin therapy — that is mechanistically distinct from statins (which raise receptor expression) and additive to them. It is given as a subcutaneous injection, typically 75 mg or 150 mg every two weeks (a monthly 300 mg option also exists).
The landmark human-outcome evidence is ODYSSEY OUTCOMES (Schwartz 2018, NEJM): in ~18,900 patients with a recent acute coronary syndrome already on intensive statins, alirocumab significantly reduced major adverse cardiovascular events (death from coronary heart disease, non-fatal MI, ischemic stroke, or unstable-angina hospitalization), with a possible reduction in all-cause mortality — a signal that strengthened in higher-risk subgroups.
Supporting trials (ODYSSEY LONG TERM, ODYSSEY FH I/II) confirm the durable, large LDL-lowering across high-risk and familial-hypercholesterolemia populations, and an imaging trial (ODYSSEY J-IVUS) examined coronary atheroma.
Alirocumab is a sibling of evolocumab — the same PCSK9-inhibitor class with the same mechanism and broadly similar effects.
The honest trade-offs are practical rather than toxic: injection-site reactions are the most characteristic adverse event, the antibody must be injected (not a pill), and historically high cost plus prior-authorization hurdles have limited access.
Alirocumab is a prescription drug for lipid management — it is described for information only, not as a supplement and not as a recommendation.
A fully human monoclonal antibody binds circulating PCSK9, preventing it from tagging LDL receptors for degradation.
With PCSK9 blocked, LDL receptors recycle back to the hepatocyte surface and keep clearing LDL-C from blood, lowering LDL ~50–60%.
Sustained, very low LDL-C reduces atherosclerotic plaque burden and major cardiovascular events in high-risk patients.
How Alirocumab (Praluent) works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
Avoid — limited human data; lipid-lowering therapy is generally paused during pregnancy.
Often a candidate group, but use is clinician-directed and access-dependent.
A studied indication (ODYSSEY FH I/II); manage under a lipid specialist.
Intended additive combination — alirocumab is designed to be layered on statins for further LDL-C lowering; not an adverse interaction.
Commonly combined; additive LDL-C lowering with no major safety interaction.
Tip: Local redness/itching/swelling; rotate sites and warm the pen to room temperature to reduce reactions.
Tip: Generally self-limited; reported at low rates above placebo in trials.
Tip: Discontinue and seek care for serious allergic reactions; rare in trials.
Alirocumab (Praluent) has an evidence score of 4.5/10 — emerging evidence based on 244 indexed studies, including 1 meta-analysis. A fully human monoclonal-antibody PCSK9 inhibitor (Praluent), injected under the skin every 2 weeks, that lowers LDL cholesterol by ~50–60%. In the ODYSSEY OUTCOMES trial of ~18,900 post-heart-attack patients it reduced major cardiovascular events and showed a possible all-cause mortality signal. Generally well tolerated; injection-site reactions and high cost/access are the main trade-offs. Prescription drug, not a supplement. Representative study: PMID 39304616.
Dosing for Alirocumab (Praluent): Prescription dosing is 75 mg or 150 mg subcutaneously every 2 weeks (a 300 mg every-4-weeks option exists), titrated by a clinician to the LDL-C target. A prescription drug; not a self-administered supplement regimen. Individual needs vary, so check the right dose for you with a healthcare provider.
Timing is flexible for Alirocumab (Praluent) — consistent daily use matters more than the time of day. A subcutaneous injection whose absorption is independent of meals; rotate injection sites (abdomen, thigh, upper arm) to limit local reactions.
Alirocumab (Praluent) should be used with caution — talk to a healthcare provider before taking it. Reported side effects include hypersensitivity / allergic reaction, injection-site reaction, nasopharyngitis / flu-like symptoms. How often they occur is not established for all of them. Use caution if any of these apply to you: Known serious hypersensitivity to alirocumab or excipients; Pregnancy (limited data; lipid lowering generally deferred in pregnancy).
Pioglitazone (Actos)
Too few graded studiesAn oral thiazolidinedione (Actos) diabetes drug that improves insulin sensitivity via PPAR-gamma. It drew geroscience interest after reducing recurrent stroke/MI in insulin-resistant non-diabetics (IRIS) and improving NASH liver histology — but weight gain, fluid retention / heart-failure risk, fracture risk, and a debated bladder-cancer signal keep enthusiasm in check. Prescription drug, not a supplement.
CoQ10
Likely helpsA lipid-soluble antioxidant central to mitochondrial energy production, with the strongest trial support for fertility/IVF outcomes and heart failure.
Red Yeast Rice
Likely helpsFermented rice containing natural statins that effectively lower LDL cholesterol — the original statin.
Berberine
Likely helpsActivates AMPK to regulate blood sugar, improve insulin sensitivity, and support lipid metabolism. Its only head-to-head trial with metformin cited here was a 36-person pilot, which does not show it can replace metformin.
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Reviewed by Dr. Baher Al Hakim · Last reviewed June 2026 · evidence from 244 studies · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.
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