ClinicalTrials.gg
CompletedNCT01764633FOURIERUpdated May 28, 2024Results posted

Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk

A Phase 3 interventional study of Evolocumab and Placebo in Dyslipidemia, sponsored by Amgen. Completed at 1,284 sites in 49 countries. Open to participants aged 40 Years to 85 Years. Per ClinicalTrials.gov, last updated 2024-05-28.

Sponsored by Amgen · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
27,564
Allocation
Randomized
Ages
40 Years to 85 Years
Sex
All
01

Study summary

The primary objective was to evaluate the effect of treatment with evolocumab, compared with placebo, on the risk for cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization, whichever occurs first, in patients with clinically evident cardiovascular disease.

02

Conditions studied

  • Dyslipidemia

Keywords

  • High cholesterol
  • Treatment for high cholesterol
  • Lowering cholesterol
  • Lowering high cholesterol
  • Hypercholesterolemia
03

In context

Dyslipidemias

1,101 studies on the registry are indexed under Dyslipidemias; 161 are open to participants now.

This study's enrollment of 27,564 is above the median of 100 across 861 interventional studies indexed under Dyslipidemias.

Browse Dyslipidemias studies →

Lead sponsor

Amgen is the lead sponsor of 1,044 studies on the registry; 51 are open to participants now.

Of its 246 completed or terminated interventional studies of FDA-regulated products, 164 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
40 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female ≥ 40 to ≤ 85 years of age
  • History of clinically evident cardiovascular disease at high risk for a recurrent event
  • Fasting low-density lipoprotein cholesterol (LDL-C) ≥ 70 mg/dL (≥ 1.8 mmol/L) ) or non-high-density lipoprotein cholesterol (non-HDL-C) ≥ 100 mg/dL (> 2.6 mmol/L)
  • Fasting triglycerides ≤ 400 mg/dL (4.5 mmol/L)

Exclusion criteria

Exclusion Criteria:

  • New York Heart Association (NYHA) class III or IV, or last known left ventricular ejection fraction \< 30%
  • Uncontrolled hypertension
  • Uncontrolled or recurrent ventricular tachycardia
  • Untreated hyperthyroidism or hypothyroidism
  • Homozygous familial hypercholesterolemia
  • LDL or plasma apheresis
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
27,564 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    Participants received placebo subcutaneous injections either once every 2 weeks (Q2W) or once a month (QM) according to their own preference.

    Drug: Placebo

  • Experimental
    Evolocumab

    Participants received evolocumab 140 mg Q2W or 420 mg QM subcutaneous injections according to their own preference.

    Biological: Evolocumab

Interventions

  • BiologicalEvolocumab

    Administered subcutaneously using a spring-based prefilled 1.0 mL autoinjector/pen.

    Also known as: AMG 145, Repatha

  • DrugPlacebo

    Administered subcutaneously using a spring-based prefilled 1.0 mL autoinjector/pen.

06

What researchers measure

Primary outcomes

  1. Time to Cardiovascular Death, Myocardial Infarction, Hospitalization for Unstable Angina, Stroke, or Coronary Revascularization

    All deaths and potential endpoint events were adjudicated by an independent external Clinical Events Committee (CEC) led by the Thrombolysis in Myocardial Infarction (TIMI) Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Time to cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization was defined as the time from randomization to the first occurrence of any component of the composite endpoint and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

Secondary outcomes

  1. Time to Cardiovascular Death, Myocardial Infarction, or Stroke

    All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Time to cardiovascular death, myocardial infarction, or stroke was defined as the time from randomization to the first occurrence of any component of the composite endpoint and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  2. Time to Cardiovascular Death

    All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Cardiovascular death includes death resulting from an acute myocardial infarction (MI), sudden cardiac death, death due to heart failure (HF), death due to stroke, death due to cardiovascular (CV) procedures, death due to CV hemorrhage, and death due to other CV causes. Time to cardiovascular death was defined as the time from randomization to the date of cardiovascular death and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on the last confirmed survival status date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  3. Time to All Cause Death

    Time to all-cause death was defined as the time from randomization to the date of death and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on the last confirmed survival status date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  4. Time to First Myocardial Infarction

    All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". The diagnosis of myocardial infarction required the combination of: * Evidence of myocardial necrosis (either changes in cardiac biomarkers or post-mortem pathological findings); and * Supporting information derived from the clinical presentation, electrocardiographic changes, or the results of myocardial or coronary artery Imaging. Time to first myocardial infarction was defined as the time from randomization to the date of the first MI and was analyzed using Kaplan-Meier survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  5. Time to First Stroke

    All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Stroke was defined as an acute episode of focal or global neurological dysfunction caused by brain, spinal cord, or retinal vascular injury as a result of hemorrhage or infarction. Time to first stroke was defined as the time from randomization to the date of the stroke and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  6. Time to First Coronary Revascularization

    All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Time to first coronary revascularization was defined as the time from randomization to the date of the coronary revascularization and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  7. Time to Cardiovascular Death or First Hospitalization for Worsening Heart Failure

    All events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions. HF hospitalization was defined as an event that met all of the following criteria: 1. Admitted to hospital with a primary diagnosis of HF 2. In hospital for at least 24 hours 3. Documented new or worsening symptoms due to HF, including at least 1 of the following: * Dyspnea * Decreased exercise tolerance * Fatigue * Other symptoms of worsened end-organ perfusion or volume overload 4. Evidence of new or worsening HF consisting of at least 2 physical exam findings or 1 physical exam finding and at least 1 laboratory criterion 5. Received new or increased treatment for HF. Time to CV death or first hospitalization for worsening HF was defined as the time from randomization to the first occurrence of any component of the endpoint analyzed using KM survival analysis. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

  8. Time to First Ischemic Fatal or Non-Fatal Stroke or Transient Ischemic Attack

    All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions. Ischemic stroke was defined as an acute episode of focal cerebral, spinal, or retinal dysfunction caused by infarction of central nervous system tissue. Transient ischemic attack (TIA) was defined as a transient episode of focal neurological dysfunction caused by brain, spinal cord, or retinal ischemia, without acute infarction. Time to first ischemic fatal or non-fatal stroke or TIA was defined as the time from randomization to the first occurrence of any component of the composite endpoint and was analyzed using KM analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

    Time frame: Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.

07

Results

Posted Feb 15, 2018

Participant flow

Participants were enrolled at 1242 clinical centers in 49 countries in the regions of Europe (62.9%), North America (16.6%), Asia Pacific (13.9%), and Latin America (6.6%) from 08 February 2013 to 05 June 2015.

Participant flow — Overall Study
MilestonePlaceboEvolocumab
Started1378013784
Received treatment1375613769
Completed1366213691
Not completed11893
Withdrew: Withdrawal by subject10588
Withdrew: Lost to follow-up135

Outcome measures

PrimaryTime to Cardiovascular Death, Myocardial Infarction, Hospitalization for Unstable Angina, Stroke, or Coronary Revascularization

All deaths and potential endpoint events were adjudicated by an independent external Clinical Events Committee (CEC) led by the Thrombolysis in Myocardial Infarction (TIMI) Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Time to cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization was defined as the time from randomization to the first occurrence of any component of the composite endpoint and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to Cardiovascular Death, Myocardial Infarction, Hospitalization for Unstable Angina, Stroke, or Coronary Revascularization
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months3.11 (2.82 to 3.40)2.74 (2.47 to 3.01)
KM estimate at 12 months6.01 (5.61 to 6.41)5.31 (4.93 to 5.68)
KM estimate at 18 months8.32 (7.86 to 8.78)7.25 (6.81 to 7.68)
KM estimate at 24 months10.66 (10.12 to 11.19)9.13 (8.63 to 9.63)
KM estimate at 30 months12.72 (12.08 to 13.35)10.91 (10.31 to 11.50)
KM estimate at 36 months14.64 (13.76 to 15.50)12.57 (11.70 to 13.42)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = < 0.0001 · Hazard ratio (hr): 0.85 · 95% CI 0.79 to 0.92Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to Cardiovascular Death, Myocardial Infarction, or Stroke

All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Time to cardiovascular death, myocardial infarction, or stroke was defined as the time from randomization to the first occurrence of any component of the composite endpoint and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to Cardiovascular Death, Myocardial Infarction, or Stroke
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months1.86 (1.63 to 2.08)1.65 (1.44 to 1.86)
KM estimate at 12 months3.68 (3.36 to 3.99)3.10 (2.81 to 3.38)
KM estimate at 18 months5.18 (4.81 to 5.55)4.29 (3.95 to 4.62)
KM estimate at 24 months6.83 (6.39 to 7.26)5.47 (5.08 to 5.86)
KM estimate at 30 months8.31 (7.78 to 8.84)6.66 (6.19 to 7.14)
KM estimate at 36 months9.93 (9.16 to 10.69)7.90 (7.17 to 8.63)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = < 0.0001 · Hazard ratio (hr): 0.80 · 95% CI 0.73 to 0.88Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to Cardiovascular Death

All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Cardiovascular death includes death resulting from an acute myocardial infarction (MI), sudden cardiac death, death due to heart failure (HF), death due to stroke, death due to cardiovascular (CV) procedures, death due to CV hemorrhage, and death due to other CV causes. Time to cardiovascular death was defined as the time from randomization to the date of cardiovascular death and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on the last confirmed survival status date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to Cardiovascular Death
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months0.40 (0.29 to 0.50)0.39 (0.29 to 0.50)
KM estimate at 12 months0.82 (0.67 to 0.97)0.79 (0.64 to 0.94)
KM estimate at 18 months1.19 (1.01 to 1.37)1.20 (1.01 to 1.38)
KM estimate at 24 months1.57 (1.36 to 1.79)1.64 (1.42 to 1.85)
KM estimate at 30 months1.99 (1.72 to 2.26)2.11 (1.83 to 2.39)
KM estimate at 36 months2.39 (1.98 to 2.80)2.49 (2.09 to 2.88)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = 0.6188 · Hazard ratio (hr): 1.05 · 95% CI 0.88 to 1.25Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to All Cause Death

Time to all-cause death was defined as the time from randomization to the date of death and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on the last confirmed survival status date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to All Cause Death
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months0.62 (0.49 to 0.75)0.55 (0.43 to 0.68)
KM estimate at 12 months1.29 (1.10 to 1.47)1.26 (1.07 to 1.44)
KM estimate at 18 months1.96 (1.73 to 2.19)1.94 (1.71 to 2.17)
KM estimate at 24 months2.78 (2.49 to 3.06)2.81 (2.52 to 3.10)
KM estimate at 30 months3.48 (3.12 to 3.83)3.63 (3.27 to 3.98)
KM estimate at 36 months4.28 (3.74 to 4.82)4.75 (4.16 to 5.34)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = 0.5368 · Hazard ratio (hr): 1.04 · 95% CI 0.91 to 1.19Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to First Myocardial Infarction

All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". The diagnosis of myocardial infarction required the combination of: * Evidence of myocardial necrosis (either changes in cardiac biomarkers or post-mortem pathological findings); and * Supporting information derived from the clinical presentation, electrocardiographic changes, or the results of myocardial or coronary artery Imaging. Time to first myocardial infarction was defined as the time from randomization to the date of the first MI and was analyzed using Kaplan-Meier survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to First Myocardial Infarction
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months1.14 (0.97 to 1.32)1.06 (0.88 to 1.23)
KM estimate at 12 months2.39 (2.13 to 2.64)1.90 (1.67 to 2.13)
KM estimate at 18 months3.33 (3.03 to 3.63)2.55 (2.28 to 2.81)
KM estimate at 24 months4.30 (3.95 to 4.65)3.21 (2.90 to 3.51)
KM estimate at 30 months5.25 (4.82 to 5.67)3.83 (3.47 to 4.19)
KM estimate at 36 months6.28 (5.67 to 6.89)4.41 (3.85 to 4.96)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = < 0.0001 · Hazard ratio (hr): 0.73 · 95% CI 0.65 to 0.82Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to First Stroke

All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Stroke was defined as an acute episode of focal or global neurological dysfunction caused by brain, spinal cord, or retinal vascular injury as a result of hemorrhage or infarction. Time to first stroke was defined as the time from randomization to the date of the stroke and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to First Stroke
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months0.50 (0.38 to 0.61)0.31 (0.22 to 0.41)
KM estimate at 12 months0.85 (0.69 to 1.00)0.70 (0.56 to 0.84)
KM estimate at 18 months1.30 (1.11 to 1.50)1.05 (0.88 to 1.22)
KM estimate at 24 months1.80 (1.57 to 2.04)1.36 (1.16 to 1.56)
KM estimate at 30 months2.15 (1.88 to 2.43)1.71 (1.46 to 1.96)
KM estimate at 36 months2.60 (2.20 to 3.00)2.18 (1.76 to 2.59)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = 0.0101 · Hazard ratio (hr): 0.79 · 95% CI 0.66 to 0.95Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to First Coronary Revascularization

All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions based on the "Standardized Definitions for Cardiovascular and Stroke End Point Events in Clinical Trials and the Third Universal Definition of Myocardial Infarction". Time to first coronary revascularization was defined as the time from randomization to the date of the coronary revascularization and was analyzed using Kaplan-Meier (KM) survival analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to First Coronary Revascularization
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months1.87 (1.65 to 2.10)1.60 (1.39 to 1.81)
KM estimate at 12 months3.71 (3.39 to 4.02)3.13 (2.84 to 3.42)
KM estimate at 18 months5.20 (4.82 to 5.57)4.16 (3.83 to 4.50)
KM estimate at 24 months6.57 (6.14 to 7.00)5.22 (4.84 to 5.61)
KM estimate at 30 months7.91 (7.39 to 8.42)6.13 (5.68 to 6.58)
KM estimate at 36 months9.17 (8.46 to 9.87)7.01 (6.36 to 7.65)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = < 0.0001 · Hazard ratio (hr): 0.78 · 95% CI 0.71 to 0.86Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to Cardiovascular Death or First Hospitalization for Worsening Heart Failure

All events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions. HF hospitalization was defined as an event that met all of the following criteria: 1. Admitted to hospital with a primary diagnosis of HF 2. In hospital for at least 24 hours 3. Documented new or worsening symptoms due to HF, including at least 1 of the following: * Dyspnea * Decreased exercise tolerance * Fatigue * Other symptoms of worsened end-organ perfusion or volume overload 4. Evidence of new or worsening HF consisting of at least 2 physical exam findings or 1 physical exam finding and at least 1 laboratory criterion 5. Received new or increased treatment for HF. Time to CV death or first hospitalization for worsening HF was defined as the time from randomization to the first occurrence of any component of the endpoint analyzed using KM survival analysis. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to Cardiovascular Death or First Hospitalization for Worsening Heart Failure
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months0.79 (0.64 to 0.93)0.64 (0.51 to 0.77)
KM estimate at 12 months1.35 (1.16 to 1.54)1.29 (1.10 to 1.48)
KM estimate at 18 months1.99 (1.75 to 2.22)1.99 (1.76 to 2.22)
KM estimate at 24 months2.70 (2.41 to 2.98)2.64 (2.36 to 2.92)
KM estimate at 30 months3.45 (3.09 to 3.81)3.31 (2.97 to 3.65)
KM estimate at 36 months4.03 (3.50 to 4.55)4.13 (3.57 to 4.68)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = 0.8179 · Hazard ratio (hr): 0.98 · 95% CI 0.86 to 1.13Based on a Cox model stratified by the randomization stratification factors.
SecondaryTime to First Ischemic Fatal or Non-Fatal Stroke or Transient Ischemic Attack

All deaths and potential endpoint events were adjudicated by an independent external CEC led by the TIMI Study Group, using standardized definitions. Ischemic stroke was defined as an acute episode of focal cerebral, spinal, or retinal dysfunction caused by infarction of central nervous system tissue. Transient ischemic attack (TIA) was defined as a transient episode of focal neurological dysfunction caused by brain, spinal cord, or retinal ischemia, without acute infarction. Time to first ischemic fatal or non-fatal stroke or TIA was defined as the time from randomization to the first occurrence of any component of the composite endpoint and was analyzed using KM analysis. KM estimates of the percentage of participants with an event are reported. Participants with no event were censored based on last non-fatal potential endpoint collection date.

Time frame:
Events that occurred from randomization to the last confirmed survival status date; the median duration of follow-up was 26 months. KM estimates at 6, 12, 18, 24, 30 and 36 months are reported.
Reported as:
Number · percentage of participants
Time to First Ischemic Fatal or Non-Fatal Stroke or Transient Ischemic Attack
percentage of participantsPlaceboEvolocumab
KM estimate at 6 months0.61 (0.48 to 0.73)0.42 (0.31 to 0.53)
KM estimate at 12 months1.05 (0.88 to 1.22)0.83 (0.67 to 0.98)
KM estimate at 18 months1.52 (1.32 to 1.73)1.18 (1.00 to 1.37)
KM estimate at 24 months2.05 (1.81 to 2.30)1.46 (1.25 to 1.66)
KM estimate at 30 months2.40 (2.11 to 2.68)1.92 (1.65 to 2.19)
KM estimate at 36 months2.81 (2.41 to 3.21)2.48 (2.01 to 2.95)
Statistical analysis
  • Placebo vs Evolocumab · Log Rank · p = 0.0035 · Hazard ratio (hr): 0.77 · 95% CI 0.65 to 0.92Based on a Cox model stratified by the randomization stratification factors.

Adverse events

Collected over From the first dose of study drug to the end of study. The median duration of follow-up was 26 months.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Placebo—3,404/13,756 (24.7%)3,438/13,756 (25%)
Evolocumab—3,410/13,769 (24.8%)3,500/13,769 (25.4%)
Most frequent serious events
Showing 10 of 1,718
Most frequent serious events
EventPlaceboEvolocumab
Angina unstableCardiac disorders278/13756233/13769
Angina pectorisCardiac disorders221/13756208/13769
PneumoniaInfections and infestations152/13756147/13769
Non-cardiac chest painGeneral disorders133/13756109/13769
Atrial fibrillationCardiac disorders132/13756119/13769
OsteoarthritisMusculoskeletal and connective tissue disorders100/1375691/13769
Peripheral arterial occlusive diseaseVascular disorders82/1375694/13769
Cardiac failureCardiac disorders66/1375666/13769
Acute kidney injuryRenal and urinary disorders64/1375664/13769
Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders64/1375664/13769
Most frequent other events
Most frequent other events
EventPlaceboEvolocumab
HypertensionVascular disorders1157/137561069/13769
Diabetes mellitusMetabolism and nutrition disorders1096/137561156/13769
NasopharyngitisInfections and infestations1021/137561067/13769
Upper respiratory tract infectionInfections and infestations649/13756692/13769

Baseline characteristics

Age, Continuous
Age, Continuous(years)PlaceboEvolocumabTotal
Mean62.5 ± 8.962.5 ± 9.162.5 ± 9.0
Age, Customized
Age, Customized(Participants)PlaceboEvolocumabTotal
< 65 years7687762315310
≥ 65 years6093616112254
Sex: Female, Male
Sex: Female, Male(Participants)PlaceboEvolocumabTotal
Female338233876769
Male103981039720795
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)PlaceboEvolocumabTotal
Hispanic or Latino108410932177
Not Hispanic or Latino126941268825382
Unknown or Not Reported235
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)PlaceboEvolocumabTotal
American Indian or Alaska Native8060140
Asian134913742723
Black or African American352317669
Native Hawaiian or Other Pacific Islander111526
White117101174823458
Multiple121931
Other266251517
Low-density Lipoprotein Cholesterol
Low-density Lipoprotein Cholesterol(Participants)PlaceboEvolocumabTotal
< 85 mg/dL480348099612
≥ 85 mg/dL8977897517952
Geographical Region
Geographical Region(Participants)PlaceboEvolocumabTotal
Europe8669866717336
North America228422864570
Latin America9109131823
Asia Pacific191719183835
08

Study locations

1,284 sites
  • Research Site
    Birmingham, Alabama 35235, United States
  • Research Site
    Birmingham, Alabama 35294, United States
  • Research Site
    Huntsville, Alabama 35801, United States
  • Research Site
    Mobile, Alabama 36608, United States
  • Research Site
    Anchorage, Alaska 99508, United States
  • Research Site
    Glendale, Arizona 85306, United States
  • Research Site
    Phoenix, Arizona 85015, United States
  • Research Site
    Phoenix, Arizona 85018, United States
  • Research Site
    Phoenix, Arizona 85054, United States
  • Research Site
    Tucson, Arizona 85712, United States
  • Research Site
    Tucson, Arizona 85723, United States
  • Research Site
    Alhambra, California 91801, United States
  • Research Site
    Banning, California 92220, United States
  • Research Site
    Beverly Hills, California 90211, United States
  • Research Site
    Encino, California 91436, United States
  • Research Site
    Escondido, California 92029, United States
  • Research Site
    Glendale, California 91204, United States
  • Research Site
    Harbor City, California 90710, United States
  • Research Site
    Huntington Beach, California 92646, United States
  • Research Site
    Laguna Hills, California 92653, United States
  • Research Site
    Long Beach, California 90807, United States
  • Research Site
    Long Beach, California 90822, United States
  • Research Site
    Los Alamitos, California 90720, United States
  • Research Site
    Los Angeles, California 90033, United States
  • Research Site
    Los Angeles, California 90048, United States
  • Research Site
    Newport Beach, California 92663, United States
  • Research Site
    Oceanside, California 92056, United States
  • Research Site
    Oxnard, California 93030, United States
  • Research Site
    Palm Springs, California 92262, United States
  • Research Site
    Roseville, California 95661, United States
  • Research Site
    Sacramento, California 95816, United States
  • Research Site
    San Diego, California 92103, United States
  • Research Site
    San Diego, California 92161, United States
  • Research Site
    San Pedro, California 90732, United States
  • Research Site
    Santa Ana, California 92704, United States
  • Research Site
    Tarzana, California 91356, United States
  • Research Site
    Thousand Oaks, California 91360, United States
  • Research Site
    Torrance, California 90502, United States
  • Research Site
    Torrance, California 90503, United States
  • Research Site
    Valley Village, California 91607, United States
  • Research Site
    Aurora, Colorado 80012, United States
  • Research Site
    Colorado Springs, Colorado 80907, United States
  • Research Site
    Colorado Springs, Colorado 80909, United States
  • Research Site
    Denver, Colorado 80218, United States
  • Research Site
    Greeley, Colorado 80631, United States
  • Research Site
    Littleton, Colorado 80120, United States
  • Research Site
    Longmont, Colorado 80501, United States
  • Research Site
    Bridgeport, Connecticut 06610, United States
  • Research Site
    Newark, Delaware 19718, United States
  • Research Site
    Seaford, Delaware 19973, United States
  • Research Site
    Wilmington, Delaware 19803, United States
  • Research Site
    Washington D.C., District of Columbia 20037, United States
  • Research Site
    Atlantis, Florida 33462, United States
  • Research Site
    Aventura, Florida 33180, United States
  • Research Site
    Bay Pines, Florida 33744, United States
  • Research Site
    Boynton Beach, Florida 33472, United States
  • Research Site
    Bradenton, Florida 34205, United States
  • Research Site
    Clearwater, Florida 33756, United States
  • Research Site
    Crystal River, Florida 34429, United States
  • Research Site
    Daytona Beach, Florida 32117, United States
  • Research Site
    Deerfield Beach, Florida 33442, United States
  • Research Site
    Delray Beach, Florida 33484, United States
  • Research Site
    Edgewater, Florida 32141, United States
  • Research Site
    Fleming Island, Florida 32003, United States
  • Research Site
    Fort Lauderdale, Florida 33308, United States
  • Research Site
    Hollywood, Florida 33021, United States
  • Research Site
    Jacksonville, Florida 32216, United States
  • Research Site
    Jacksonville Beach, Florida 32250, United States
  • Research Site
    Lakeland, Florida 33805, United States
  • Research Site
    Largo, Florida 33777, United States
  • Research Site
    Melbourne, Florida 32901, United States
  • Research Site
    Miami, Florida 33144, United States
  • Research Site
    Miami, Florida 33155, United States
  • Research Site
    Miami, Florida 33173, United States
  • Research Site
    New Port Richey, Florida 34653, United States
  • Research Site
    Orlando, Florida 32806, United States
  • Research Site
    Palm Harbor, Florida 34684, United States
  • Research Site
    Pembroke Pines, Florida 33024, United States
  • Research Site
    Pembroke Pines, Florida 33028, United States
  • Research Site
    Pensacola, Florida 32501, United States
  • Research Site
    Ponte Vedra, Florida 32081, United States
  • Research Site
    Port Charlotte, Florida 33952, United States
  • Research Site
    Safety Harbor, Florida 34695, United States
  • Research Site
    Sanford, Florida 32771, United States
  • Research Site
    Sarasota, Florida 34232, United States
  • Research Site
    Sarasota, Florida 34239, United States
  • Research Site
    St. Petersburg, Florida 33709, United States
  • Research Site
    St. Petersburg, Florida 33713, United States
  • Research Site
    Tampa, Florida 33614, United States
  • Research Site
    Wellington, Florida 33449, United States
  • Research Site
    West Palm Beach, Florida 33401, United States
  • Research Site
    Athens, Georgia 30606, United States
  • Research Site
    Atlanta, Georgia 30342, United States
  • Research Site
    Augusta, Georgia 30909, United States
  • Research Site
    Dunwoody, Georgia 30338, United States
  • Research Site
    East Point, Georgia 30344, United States
  • Research Site
    Eatonton, Georgia 31024, United States
  • Research Site
    Gainesville, Georgia 30501, United States
  • Research Site
    Macon, Georgia 31201, United States
  • Research Site
    Savannah, Georgia 31406, United States

Showing the first 100 of 1,284 sites across 49 countries.

09

References and documents

Publications

  • Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, Kuder JF, Wang H, Liu T, Wasserman SM, Sever PS, Pedersen TR; FOURIER Steering Committee and Investigators. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017 May 4;376(18):1713-1722. doi: 10.1056/NEJMoa1615664. Epub 2017 Mar 17. PubMed 28304224 ↗
  • Fonarow GC, Keech AC, Pedersen TR, Giugliano RP, Sever PS, Lindgren P, van Hout B, Villa G, Qian Y, Somaratne R, Sabatine MS. Cost-effectiveness of Evolocumab Therapy for Reducing Cardiovascular Events in Patients With Atherosclerotic Cardiovascular Disease. JAMA Cardiol. 2017 Oct 1;2(10):1069-1078. doi: 10.1001/jamacardio.2017.2762. PubMed 28832867 ↗
  • Fonarow GC, van Hout B, Villa G, Arellano J, Lindgren P. Updated Cost-effectiveness Analysis of Evolocumab in Patients With Very High-risk Atherosclerotic Cardiovascular Disease. JAMA Cardiol. 2019 Jul 1;4(7):691-695. doi: 10.1001/jamacardio.2019.1647. PubMed 31166576 ↗
  • Schludi B, Giugliano RP, Sabatine MS, Raal FJ, Teramoto T, Koren MJ, Stein EA, Wang H, Monsalvo ML. Time-averaged low-density lipoprotein cholesterol lowering with evolocumab: Pooled analysis of phase 2 trials. J Clin Lipidol. 2022 Jul-Aug;16(4):538-543. doi: 10.1016/j.jacl.2022.05.069. Epub 2022 Jun 6. PubMed 35760720 ↗
  • Berg DD, Moura FA, Bellavia A, Scirica BM, Wiviott SD, Bhatt DL, Raz I, Bohula EA, Giugliano RP, Park JG, Feinberg MW, Braunwald E, Morrow DA, Sabatine MS. Assessment of Atherothrombotic Risk in Patients With Type 2 Diabetes Mellitus. J Am Coll Cardiol. 2023 Jun 27;81(25):2391-2402. doi: 10.1016/j.jacc.2023.04.031. PubMed 37344040 ↗
  • Clinical Benefit of Evolocumab Treatment Among Patients With Atherosclerotic Cardiovascular Disease: Exploration Based on the Chinese Subgroup of FOURIER Study, ZHANG Lihua1 , LI Weimin2 , YAO Zhuhua3 , CHEN Jiyan4 , DONG Jun5 , LI Jing1 (Chinese Circulation Journal, 2023, 38: 704.)
  • Monguillon V, Kelly PJ, O'Donoghue ML, Park JG, Bohula EA, Saver JL, Atar D, Keech AC, Sever PS, Wang H, Paiva da Silva Lima G, Sabatine MS, Giugliano RP. Efficacy and Safety of Very Low Achieved LDL Cholesterol in Patients With Previous Ischemic Stroke. Circulation. 2026 Jan 13;153(2):86-93. doi: 10.1161/CIRCULATIONAHA.125.077549. Epub 2025 Nov 3. PubMed 41178569 ↗
  • Zimerman A, Kunzler ALF, Weber BN, Ran X, Murphy SA, Wang H, Honarpour N, Keech AC, Sever PS, Sabatine MS, Giugliano RP. Intensive Lowering of LDL Cholesterol Levels With Evolocumab in Autoimmune or Inflammatory Diseases: An Analysis of the FOURIER Trial. Circulation. 2025 May 20;151(20):1467-1476. doi: 10.1161/CIRCULATIONAHA.124.072756. Epub 2025 Apr 21. PubMed 40255182 ↗
  • Gaba P, O'Donoghue ML, Park JG, Wiviott SD, Atar D, Kuder JF, Im K, Murphy SA, De Ferrari GM, Gaciong ZA, Toth K, Gouni-Berthold I, Lopez-Miranda J, Schiele F, Mach F, Flores-Arredondo JH, Lopez JAG, Elliott-Davey M, Wang B, Monsalvo ML, Abbasi S, Giugliano RP, Sabatine MS. Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes: An Analysis of FOURIER-OLE. Circulation. 2023 Apr 18;147(16):1192-1203. doi: 10.1161/CIRCULATIONAHA.122.063399. Epub 2023 Feb 13. PubMed 36779348 ↗
  • Erviti J, Wright J, Bassett K, Ben-Eltriki M, Jauca C, Saiz LC, Leache L, Gutierrez-Valencia M, Perry TL. Restoring mortality data in the FOURIER cardiovascular outcomes trial of evolocumab in patients with cardiovascular disease: a reanalysis based on regulatory data. BMJ Open. 2022 Dec 30;12(12):e060172. doi: 10.1136/bmjopen-2021-060172. PubMed 36585131 ↗
  • Fagundes A Jr, Morrow DA, Oyama K, Furtado RHM, Zelniker TA, Tang M, Kuder JF, Murphy SA, Hamer A, Keech AC, Sever P, Giugliano RP, Sabatine MS, Bergmark BA. Biomarker Prediction of Complex Coronary Revascularization Procedures in the FOURIER Trial. J Am Coll Cardiol. 2022 Aug 30;80(9):887-897. doi: 10.1016/j.jacc.2022.05.051. PubMed 36007987 ↗
  • Furtado RHM, Fagundes AA Jr, Oyama K, Zelniker TA, Tang M, Kuder JF, Murphy SA, Hamer A, Wang H, Keech AC, Giugliano RP, Sabatine MS, Bergmark BA. Effect of Evolocumab in Patients With Prior Percutaneous Coronary Intervention. Circ Cardiovasc Interv. 2022 Mar;15(3):e011382. doi: 10.1161/CIRCINTERVENTIONS.121.011382. Epub 2022 Feb 25. PubMed 35209731 ↗
  • Oyama K, Giugliano RP, Tang M, Bonaca MP, Saver JL, Murphy SA, Ruzza A, Keech AC, Sever PS, Sabatine MS, Bergmark BA. Effect of evolocumab on acute arterial events across all vascular territories : results from the FOURIER trial. Eur Heart J. 2021 Dec 14;42(47):4821-4829. doi: 10.1093/eurheartj/ehab604. PubMed 34537830 ↗
  • Keech AC, Oyama K, Sever PS, Tang M, Murphy SA, Hirayama A, Lu C, Tay L, Deedwania PC, Siu CW, Lira Pineda A, Choi D, Charng MJ, Amerena J, Wan Ahmad WA, Chopra VK, Pedersen TR, Giugliano RP, Sabatine MS; FOURIER Study Group. Efficacy and Safety of Long-Term Evolocumab Use Among Asian Subjects - A Subgroup Analysis of the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) Trial. Circ J. 2021 Oct 25;85(11):2063-2070. doi: 10.1253/circj.CJ-20-1051. Epub 2021 May 15. PubMed 33980763 ↗
  • Oyama K, Furtado RHM, Fagundes A Jr, Zelniker TA, Tang M, Kuder J, Murphy SA, Hamer A, Wang H, Keech AC, Giugliano RP, Sabatine MS, Bergmark BA. Effect of Evolocumab on Complex Coronary Disease Requiring Revascularization. J Am Coll Cardiol. 2021 Jan 26;77(3):259-267. doi: 10.1016/j.jacc.2020.11.011. Epub 2020 Nov 13. PubMed 33197560 ↗
  • Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP. PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Oct 20;10(10):CD011748. doi: 10.1002/14651858.CD011748.pub3. PubMed 33078867 ↗
  • Deedwania P, Murphy SA, Scheen A, Badariene J, Pineda AL, Honarpour N, Keech AC, Sever PS, Pedersen TR, Sabatine MS, Giugliano RP. Efficacy and Safety of PCSK9 Inhibition With Evolocumab in Reducing Cardiovascular Events in Patients With Metabolic Syndrome Receiving Statin Therapy: Secondary Analysis From the FOURIER Randomized Clinical Trial. JAMA Cardiol. 2021 Feb 1;6(2):139-147. doi: 10.1001/jamacardio.2020.3151. PubMed 32785614 ↗
  • Gencer B, Mach F, Murphy SA, De Ferrari GM, Huber K, Lewis BS, Ferreira J, Kurtz CE, Wang H, Honarpour N, Keech AC, Sever PS, Pedersen TR, Sabatine MS, Giugliano RP. Efficacy of Evolocumab on Cardiovascular Outcomes in Patients With Recent Myocardial Infarction: A Prespecified Secondary Analysis From the FOURIER Trial. JAMA Cardiol. 2020 Aug 1;5(8):952-957. doi: 10.1001/jamacardio.2020.0882. PubMed 32432684 ↗
  • Bergmark BA, O'Donoghue ML, Murphy SA, Kuder JF, Ezhov MV, Ceska R, Gouni-Berthold I, Jensen HK, Tokgozoglu SL, Mach F, Huber K, Gaciong Z, Lewis BS, Schiele F, Jukema JW, Pedersen TR, Giugliano RP, Sabatine MS. An Exploratory Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial. JAMA Cardiol. 2020 Jun 1;5(6):709-713. doi: 10.1001/jamacardio.2020.0728. PubMed 32347887 ↗
  • Wiviott SD, Giugliano RP, Morrow DA, De Ferrari GM, Lewis BS, Huber K, Kuder JF, Murphy SA, Forni DM, Kurtz CE, Honarpour N, Keech AC, Sever PS, Pedersen TR, Sabatine MS. Effect of Evolocumab on Type and Size of Subsequent Myocardial Infarction: A Prespecified Analysis of the FOURIER Randomized Clinical Trial. JAMA Cardiol. 2020 Jul 1;5(7):787-793. doi: 10.1001/jamacardio.2020.0764. PubMed 32347885 ↗
  • Giugliano RP, Pedersen TR, Saver JL, Sever PS, Keech AC, Bohula EA, Murphy SA, Wasserman SM, Honarpour N, Wang H, Lira Pineda A, Sabatine MS; FOURIER Investigators. Stroke Prevention With the PCSK9 (Proprotein Convertase Subtilisin-Kexin Type 9) Inhibitor Evolocumab Added to Statin in High-Risk Patients With Stable Atherosclerosis. Stroke. 2020 May;51(5):1546-1554. doi: 10.1161/STROKEAHA.119.027759. Epub 2020 Apr 21. PubMed 32312223 ↗
  • Charytan DM, Sabatine MS, Pedersen TR, Im K, Park JG, Pineda AL, Wasserman SM, Deedwania P, Olsson AG, Sever PS, Keech AC, Giugliano RP; FOURIER Steering Committee and Investigators. Efficacy and Safety of Evolocumab in Chronic Kidney Disease in the FOURIER Trial. J Am Coll Cardiol. 2019 Jun 18;73(23):2961-2970. doi: 10.1016/j.jacc.2019.03.513. PubMed 31196453 ↗
  • Murphy SA, Pedersen TR, Gaciong ZA, Ceska R, Ezhov MV, Connolly DL, Jukema JW, Toth K, Tikkanen MJ, Im K, Wiviott SD, Kurtz CE, Honarpour N, Giugliano RP, Keech AC, Sever PS, Sabatine MS. Effect of the PCSK9 Inhibitor Evolocumab on Total Cardiovascular Events in Patients With Cardiovascular Disease: A Prespecified Analysis From the FOURIER Trial. JAMA Cardiol. 2019 Jul 1;4(7):613-619. doi: 10.1001/jamacardio.2019.0886. PubMed 31116355 ↗
  • O'Donoghue ML, Fazio S, Giugliano RP, Stroes ESG, Kanevsky E, Gouni-Berthold I, Im K, Lira Pineda A, Wasserman SM, Ceska R, Ezhov MV, Jukema JW, Jensen HK, Tokgozoglu SL, Mach F, Huber K, Sever PS, Keech AC, Pedersen TR, Sabatine MS. Lipoprotein(a), PCSK9 Inhibition, and Cardiovascular Risk. Circulation. 2019 Mar 19;139(12):1483-1492. doi: 10.1161/CIRCULATIONAHA.118.037184. PubMed 30586750 ↗
  • Qamar A, Giugliano RP, Keech AC, Kuder JF, Murphy SA, Kurtz CE, Wasserman SM, Sever PS, Pedersen TR, Sabatine MS. Interindividual Variation in Low-Density Lipoprotein Cholesterol Level Reduction With Evolocumab: An Analysis of FOURIER Trial Data. JAMA Cardiol. 2019 Jan 1;4(1):59-63. doi: 10.1001/jamacardio.2018.4178. PubMed 30540337 ↗
  • Martin SS, Giugliano RP, Murphy SA, Wasserman SM, Stein EA, Ceska R, Lopez-Miranda J, Georgiev B, Lorenzatti AJ, Tikkanen MJ, Sever PS, Keech AC, Pedersen TR, Sabatine MS. Comparison of Low-Density Lipoprotein Cholesterol Assessment by Martin/Hopkins Estimation, Friedewald Estimation, and Preparative Ultracentrifugation: Insights From the FOURIER Trial. JAMA Cardiol. 2018 Aug 1;3(8):749-753. doi: 10.1001/jamacardio.2018.1533. PubMed 29898218 ↗
  • Sabatine MS, De Ferrari GM, Giugliano RP, Huber K, Lewis BS, Ferreira J, Kuder JF, Murphy SA, Wiviott SD, Kurtz CE, Honarpour N, Keech AC, Sever PS, Pedersen TR. Clinical Benefit of Evolocumab by Severity and Extent of Coronary Artery Disease: Analysis From FOURIER. Circulation. 2018 Aug 21;138(8):756-766. doi: 10.1161/CIRCULATIONAHA.118.034309. PubMed 29626068 ↗
  • Bohula EA, Giugliano RP, Leiter LA, Verma S, Park JG, Sever PS, Lira Pineda A, Honarpour N, Wang H, Murphy SA, Keech A, Pedersen TR, Sabatine MS. Inflammatory and Cholesterol Risk in the FOURIER Trial. Circulation. 2018 Jul 10;138(2):131-140. doi: 10.1161/CIRCULATIONAHA.118.034032. Epub 2018 Mar 12. PubMed 29530884 ↗
  • Bonaca MP, Nault P, Giugliano RP, Keech AC, Pineda AL, Kanevsky E, Kuder J, Murphy SA, Jukema JW, Lewis BS, Tokgozoglu L, Somaratne R, Sever PS, Pedersen TR, Sabatine MS. Low-Density Lipoprotein Cholesterol Lowering With Evolocumab and Outcomes in Patients With Peripheral Artery Disease: Insights From the FOURIER Trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). Circulation. 2018 Jan 23;137(4):338-350. doi: 10.1161/CIRCULATIONAHA.117.032235. Epub 2017 Nov 13. PubMed 29133605 ↗
  • Sabatine MS, Leiter LA, Wiviott SD, Giugliano RP, Deedwania P, De Ferrari GM, Murphy SA, Kuder JF, Gouni-Berthold I, Lewis BS, Handelsman Y, Pineda AL, Honarpour N, Keech AC, Sever PS, Pedersen TR. Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial. Lancet Diabetes Endocrinol. 2017 Dec;5(12):941-950. doi: 10.1016/S2213-8587(17)30313-3. Epub 2017 Sep 15. PubMed 28927706 ↗
  • Giugliano RP, Pedersen TR, Park JG, De Ferrari GM, Gaciong ZA, Ceska R, Toth K, Gouni-Berthold I, Lopez-Miranda J, Schiele F, Mach F, Ott BR, Kanevsky E, Pineda AL, Somaratne R, Wasserman SM, Keech AC, Sever PS, Sabatine MS; FOURIER Investigators. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. Lancet. 2017 Oct 28;390(10106):1962-1971. doi: 10.1016/S0140-6736(17)32290-0. Epub 2017 Aug 28. PubMed 28859947 ↗
10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Feb 2013 to primary completion in Nov 2016, 45 months.

Results were first posted in Feb 2018, 1 year 3 months after primary completion. A results delay was requested in Jun 2017.

Of 55 industry-sponsored phase 3 interventional studies under Dyslipidemias, half reached primary completion within 22 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 36. This study's 45 months is above that.

Counting every sponsor, half of 65 studies reached it within 22 months; a quarter within 12 and three quarters within 43.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 8, 2013
First posted
Jan 9, 2013
StartActual
Feb 8, 2013
Primary completionActual
Nov 11, 2016
CompletionActual
Nov 11, 2016
Results delay requested
Jun 19, 2017
Results first posted
Feb 15, 2018
Last update
May 28, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 28, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01764633
Lead sponsor
Amgen
Responsible party
Sponsor
First posted
Jan 9, 2013
Start date
Feb 8, 2013
Primary completion
Nov 11, 2016
Completion
Nov 11, 2016
Results posted
Feb 15, 2018
Last update
May 28, 2024

Study contacts

MD
study director · Amgen

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2024. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drug tested here: Evolocumab

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