Impact of Inhibition of Pcsk-9 Among Renal Transplant Recipi
About 195 kidney transplant recipients—with high cardiovascular risk (>20)—were enrolled in this randomized controlled study during the period between 6.2017 and 6.2018. Patients who received statin and evolocumab (140 mg/2 weeks, group 1, n = 97) while those who were maintained on statin alone comprised group 2 (n = 98). They were followed up for 24 months.

The two groups were comparable regarding their demographics (P > 0.05). Before enrollment in the study, post-transplant complications were comparable apart from a higher prevalence of NODAT in group 2 (P = 0.033). Smokers were significantly more prevalent in group 1. Basal graft function was significantly higher in group 1 despite equivalent regimen of immunosuppression in both groups (P > 0.05). Clinically two groups were comparable concerning cardiovascular events and both graft and patient outcomes (P > 0.05). Basal cholesterol was significantly higher in group 1 (5.5 versus 4.7, P < 0.001) which dropped significantly after 3 months (versus12 months in group 2) and thereafter (P = 0.031). We observed that triglycerides in the two groups were comparable (P > 0.05) till the end of the study.

Evolocumab is a promising add on lipid-lowering agent. In high risk renal transplant, earlier reduction of cholesterol was observed in the add-on evolocumab group but without significant positive cardiovascular impact.