We use essential cookies (authentication, your saved goals/stack) by default. With your permission we’ll also enable privacy-respecting analytics (Vercel Web Analytics, anonymous load-time metrics) and error-replay diagnostics (Sentry — DOM snapshots only when an error fires) so we can fix bugs faster. Learn more about cookies
Evolocumab (Repatha) — PCSK9-inhibitor monoclonal antibody
A prescription PCSK9-inhibitor monoclonal antibody (Repatha) given by subcutaneous injection. By binding circulating PCSK9 it spares LDL receptors and lowers LDL cholesterol by roughly 60%. The landmark FOURIER trial in ~27,500 statin-treated patients showed it cut cardiovascular events, and it produces dramatic LDL lowering in familial hypercholesterolemia. Very safe apart from injection-site reactions; cost and injection burden are the main trade-offs. A prescription drug, not a supplement.
Prescription medication — not a dietary supplement
Evolocumab (Repatha) 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
Most Evolocumab (Repatha) studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 2012–2026 with a typical study size of 115 participants.
Based on 140 studies · 7 meta-analyses · 125 RCTs · 115 total participants
Confidence
High confidenceBy outcome
Evolocumab has strong randomized evidence: FOURIER (~27,500 patients) showed reduced cardiovascular events on top of statins, GLAGOV showed coronary plaque regression, and it lowers LDL-C by ~60% including in familial hypercholesterolemia. It is very safe apart from injection-site reactions. The trade-offs that keep it short of the top are high cost/access barriers and injection burden — and there is no demonstrated general longevity benefit beyond cardiovascular event reduction.
233 rigorous studies
136 randomized trials · 71 meta-analyses · 68 systematic reviews
Our evidence rating for Evolocumab (Repatha) is accountable to this entire body of rigorous research indexed in PubMed — not a hand-picked subset.
PubMed · as of Jul 2026
35 trials ongoing or recruiting · 80 completed on ClinicalTrials.gov
53 of the completed trials have posted results
Registered trials show research momentum for Evolocumab (Repatha), 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 Aug 2026
Evolocumab is a fully human monoclonal antibody that inhibits PCSK9 (proprotein convertase subtilisin/kexin type 9).
PCSK9 normally binds LDL receptors on the liver and routes them for degradation; by neutralizing circulating PCSK9, evolocumab lets LDL receptors recycle back to the cell surface and clear more LDL cholesterol from the blood — lowering LDL-C by approximately 60%, on top of statins.
It is delivered by subcutaneous injection (140 mg every two weeks or 420 mg monthly).
The cardiovascular-outcomes case is unusually strong for a lipid drug: in FOURIER (Sabatine et al., 2017, ~27,500 statin-treated patients with atherosclerotic disease) evolocumab significantly reduced major cardiovascular events, and the FOURIER open-label extension (FOURIER-OLE) suggested continued and possibly growing benefit with longer exposure.
In imaging, the GLAGOV trial showed regression of coronary atherosclerotic plaque, and in heterozygous familial hypercholesterolemia (RUTHERFORD-2) it produced large LDL reductions in patients who cannot reach goal on statins alone. It is also used in statin-intolerant patients (GAUSS-3).
The honest framing: the proven outcome is fewer cardiovascular events and dramatic LDL lowering — there is no demonstrated general 'longevity' or lifespan benefit, and the trade-offs are real: high cost and access barriers, an injection burden, the theoretical immunogenicity of any antibody, and injection-site reactions.
Very low achieved LDL levels have not shown clear harm in trials to date. Evolocumab is a prescription drug; this is an informational entry, not a recommendation — lipid-lowering therapy must be directed by a clinician.
The score reflects genuinely strong randomized cardiovascular-outcome and LDL-lowering data against the cost, access, and injection trade-offs of a specialist drug.
Binds circulating PCSK9 so it can no longer mark LDL receptors for degradation, the antibody's core action.
With PCSK9 blocked, hepatic LDL receptors recycle back to the cell surface and clear far more LDL cholesterol from the blood.
Sustained ~60% LDL lowering on top of statins slows or regresses atherosclerotic plaque and reduces cardiovascular events.
How Evolocumab (Repatha) 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.
A primary indication — large LDL reductions where statins alone fall short, under specialist care.
Studied (GAUSS-3) as an option when statins are not tolerated, directed by a clinician.
Limited human data; antibodies cross the placenta in later pregnancy — discuss with a clinician and generally avoid.
Intentionally combined — additive LDL lowering; this is the studied use, not an adverse interaction.
Often layered for additive LDL lowering; no harmful interaction, used together by design.
Tip: Redness, pain, or bruising at the site; rotate injection sites and let the pen reach room temperature first.
Tip: Mild cold-like symptoms reported in trials; usually self-limited.
Tip: As with any monoclonal antibody, allergic reactions and anti-drug antibodies are possible; seek care for rash, swelling, or breathing difficulty.
Evolocumab (Repatha) has an evidence score of 4.5/10 — emerging evidence based on 120 indexed studies. A prescription PCSK9-inhibitor monoclonal antibody (Repatha) given by subcutaneous injection. By binding circulating PCSK9 it spares LDL receptors and lowers LDL cholesterol by roughly 60%. The landmark FOURIER trial in ~27,500 statin-treated patients showed it cut cardiovascular events, and it produces dramatic LDL lowering in familial hypercholesterolemia. Very safe apart from injection-site reactions; cost and injection burden are the main trade-offs. A prescription drug, not a supplement. Representative study: PMID 33078867.
The commonly studied dose of Evolocumab (Repatha) is Standard approved dosing is 140 mg subcutaneously every 2 weeks OR 420 mg subcutaneously once monthly, under a clinician. A prescription drug; this is informational, not a recommendation.. Individual needs vary — start at the lower end of the range and adjust based on how you respond.
Timing is flexible for Evolocumab (Repatha) — consistent daily use matters more than the time of day. A subcutaneous antibody injection; timing of day is not critical.
Evolocumab (Repatha) is generally safe at recommended doses, with a few precautions worth noting. The most commonly reported side effects are injection-site reactions, nasopharyngitis / upper-respiratory symptoms, hypersensitivity / antibody response. Use caution if any of these apply to you: Prior serious hypersensitivity reaction to evolocumab; Use only under clinician direction as part of a lipid-management plan.
Pioglitazone (Actos)
Mostly mechanism / observationalAn 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 — comparable to metformin in some trials.
Explore: Best supplements for Vitality & Longevity
Reviewed by Dr. Baher Al Hakim · Last reviewed June 2026 · evidence from 141 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.
Tap node to isolate • Pinch to zoom • Tap edge for research