The injectable monoclonal antibody evolocumab has been shown to reduce low-density lipoprotein (LDL) cholesterol levels by more than 50% in patients with hypercholesterolaemia.¹ However, evidence on its effect on cardiovascular events is limited, partly because trials have focussed on a primary outcome of reduction in LDL cholesterol but also as a result of low numbers of cardiovascular events in trials.^2,3 A large randomised double-blind placebo-controlled trial has assessed the effectiveness of evolocumab in reducing major cardiovascular events using a composite outcome of cardiovascular death, myocardial infarction, stroke, hospitalisation for unstable angina, or coronary revascularisation.³

The trial (1,272 …