Evolocumab in Patients with Cardiovascular Disease

To the Editor: Sabatine et al. (May 4 issue)¹ report the results of the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial. The addition of evolocumab to standard therapy was associated with an absolute risk reduction of 2 percentage points in both the primary and secondary end points after a median duration of follow-up of 26 months. The fact that approximately 30% of the patients were receiving moderate-intensity statin therapy and the lack of clinical efficacy of evolocumab in the small group of patients receiving ezetimibe (presumably combined with a statin) arouse concern about . . .