Evolocumab in paediatric heterozygous familial hypercholesterolaemia: cognitive function during 80 weeks of open-label extension treatment.

Journal: European journal of preventive cardiology

Volume: 31

Issue: 3

Year of Publication: 2024

Affiliated Institutions:  Lipid Clinic Heart Institute (InCor), University of Sao Paulo Medical School Hospital and Hospital Israelita Albert Einstein, Av. Dr Enéas C. Aguiar , Sao Paulo -, Brazil. Global Development, Amgen, Thousand Oaks, CA, USA. Biostatistics Department, Amgen, Thousand Oaks, CA, USA. Cogstate Ltd., Melbourne, VIC, Australia. Cardiology Department, Geneva University Hospital, Geneva, Switzerland. Lipid Clinic, Department of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, QC, Canada. Department of Health Sciences, Université du Quebec à Chicoutimi, and ECOGENE-, Chicoutimi, QC, Canada. Department of Pediatrics, Faculty of Medicine, McGill University, Montréal, QC, Canada. Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands. Department of Pediatrics, Amsterdam UMC, Amsterdam, Netherlands. The Clinical Lipidology and Rare Lipid Disorders Unit, Community Genomic Medicine Centre and ECOGENE-, Department of Medicine, Université de Montréal, Chicoutimi, QC, Canada. Division of Endocrinology and Metabolism, Department of Medicine Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract summary 

PCSK9 inhibition intensively lowers low density lipoprotein cholesterol and is well tolerated in adults and paediatric patients with familial hypercholesterolaemia (FH). HAUSER-RCT showed that 24 weeks of treatment with evolocumab in paediatric patients did not affect cognitive function. This study determined the effects of 80 additional weeks of evolocumab treatment on cognitive function in paediatric patients with heterozygous FH.HAUSER-OLE was an 80-week open-label extension of HAUSER-RCT, a randomized, double-blind, 24-week trial evaluating the efficacy and safety of evolocumab in paediatric patients (ages 10-17 years) with FH. During the OLE, all patients received monthly 420 mg subcutaneous evolocumab injections. Tests of psychomotor function, attention, visual learning, and executive function were administered at baseline and Weeks 24 and 80 of the OLE. Changes over time were analysed descriptively and using analysis of covariance. Cohen's d statistic was used to evaluate the magnitude of treatment effects. Analysis of covariance results indicated no decrease in performance across visits during 80 weeks of evolocumab treatment for Groton Maze Learning, One Card Learning accuracy, Identification speed, or Detection speed (all P > 0.05). Performance on all tasks was similar for those who received placebo or evolocumab in the RCT (all P > 0.05). For all tests, the least square mean differences between patients who received placebo vs. evolocumab in the parent study were trivial (all Cohen's d magnitude < 0.2).In paediatric patients with FH, 80 weeks of open-label evolocumab treatment had no negative impact on cognitive function.ClinicalTrials.gov identifier: NCT02624869.

Authors & Co-authors:  Santos Raul D RD Ruzza Andrea A Wang Bei B Maruff Paul P Schembri Adrian A Bhatia Ajay K AK Mach François F Bergeron Jean J Gaudet Isabelle I St Pierre Julie J Kastelein John J P JJP Hovingh G Kees GK Wiegman Albert A Gaudet Daniel D Raal Frederick J FJ

Study Outcome 

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Statistics
Citations : 
Authors :  15
Identifiers
Doi : 10.1093/eurjpc/zwad332
SSN : 2047-4881
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Atherosclerotic cardiovascular disease;Central nervous system;Children;Low density lipoprotein cholesterol;Proprotein convertase subtilisin kexin 9 (PCSK9);Safety
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England