Not everyone can tolerate statins to lower cholesterol. Some people react to drugs like atorvastatin, lovastatin, pravastatin, rosuvastatin or simvastatin with muscle pain and weakness, arthritis, muscle cramps, digestive distress or neuropathy . Others complain of cognitive problems or forgetfulness. Evolocumab (Repatha) has been approved to treat high cholesterol levels together with a statin. But what about all by itself? This reader shares a success story with Repatha alone. Will Repatha substitute for statins?
Repatha Instead of Statins:
Q. I have been plagued with high cholesterol most of my life. Doctors put me on statins and the result was terrible pain and loss of short-term memory.
The statins lowered my cholesterol from the 300s down into the 200s, but the side effects were totally unacceptable. Switching statins and lowering the dosage didn’t help.
My new doctor prescribed Repatha and within six weeks my cholesterol dropped to 107 with no side effects. I have been on Repatha for six months now and can’t say enough about the new treatment.
A. Evolocumab (Repatha) is a relatively new injectable cholesterol-lowering medicine. It is approved for people with heart disease or those who have familial (inherited) super-high cholesterol.
Repatha is usually prescribed together with a statin. However, some doctors are prescribing it for patients who can’t tolerate statin side effects. Is it kosher to have Repatha substitute for statins? There is no good answer. The study published in the New England Journal of Medicine (May 4, 2017) showed that Repatha plus a statin reduced heart attacks, strokes and the need for stents more than placebo plus statin.
Doctors can prescribe medications any way they deem appropriate. The FDA’s “indications” are guidelines or recommendations. Drugs get approval for specific indications based on clinical trials. We cannot tell you how well Repatha works all by itself. How well did Repatha work when combined with a statin?
What About Absolute vs. Relative Risk Reduction?
It is crucial for physicians and patients to understand the difference between relative risk reduction and absolute risk reduction. The FOURIER study published in the New England Journal of Medicine reveals some interesting stats. Remember, this study involved a statin plus Repatha.
The relative risk reduction for a stent, stroke or heart attack was between 21 and 27 percent. Sounds impressive. But the absolute risk reduction was 1.5 out of 100. Confused? Here is an article that explains the pros and cons of Repatha in greater detail and this absolute vs. relative thing.
What About Repatha Side Effects?
Side effects are relatively uncommon. Some people experience serious allergic reactions, flu-like symptoms such as sore throat and cough, back pain, headache, muscle pain, dizziness or digestive distress.
If insurance covers the cost of Repatha, you are fortunate. Otherwise the drug is very expensive. More about cost at this link:
Share your own experience with Repatha below in the comment section.