FOURIER Trial
New England Journal of Medicine (2017)
Reduced LDL by 59% (median 92→30 mg/dL) and MACE by 15%, MI by 27%, stroke by 21% in 27,564 patients.
Evolocumab (Repatha)
Injectable (SubQ), 140mg/mL SureClick auto-injector penAvailable in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
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Evolocumab (Repatha)Evolocumab (Repatha)
Fully human monoclonal antibody targeting PCSK9, dramatically increasing LDL receptor recycling. Produces 55 to 60% LDL reduction on top of statin therapy. FOURIER trial demonstrated significant MACE reduction.
55 to 60% LDL reduction on top of statin
FOURIER: 15% MACE reduction, 27% MI reduction
Also reduces Lp(a) by 20 to 30%
Atherosclerotic plaque regression (GLAGOV)
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Binds free circulating PCSK9, preventing it from targeting LDL receptors for lysosomal degradation. Dramatically increases LDL receptor density on hepatocytes, enhancing LDL-C clearance.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Evolocumab (Repatha).
GLAGOV Trial: Plaque Regression
JAMA (2016)
Significant coronary plaque volume regression by IVUS at LDL ~37 mg/dL.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Injection site reactions
- Nasopharyngitis
- Back pain
- Influenza-like symptoms
Less common but serious risks
- No serious class-specific risks established
- Very low LDL levels appear safe (EBBINGHAUS confirmed no cognitive effects)
Generally not appropriate for
- Prior serious hypersensitivity to evolocumab
Typical monitoring
- Lipid panel (LDL-C, ApoB, Lp(a))
- Liver function (baseline)
- Cognitive assessment if symptomatic
FAQ
Quick answers.
Fully human monoclonal antibody targeting PCSK9, dramatically increasing LDL receptor recycling. Produces 55 to 60% LDL reduction on top of statin therapy. FOURIER trial demonstrated significant MACE reduction.
55 to 60% LDL reduction on top of statin. FOURIER: 15% MACE reduction, 27% MI reduction. Also reduces Lp(a) by 20 to 30%. Atherosclerotic plaque regression (GLAGOV).
Common side effects include: injection site reactions, nasopharyngitis, back pain, influenza-like symptoms. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
Fully human monoclonal antibody targeting PCSK9, dramatically increasing LDL receptor recycling. Produces 55 to 60% LDL reduction on top of statin therapy. FOURIER trial demonstrated significant MACE reduction.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.