INDICATIONS

Repatha® is indicated:

  • To reduce the risk of major adverse cardiovascular (CV) events (CV death, myocardial infarction, stroke, unstable angina requiring ... READ MORE

For US healthcare professionals

2026 ACC/AHA/Multisociety guideline is here

AFTER 8 YEARS, LDL-C GOALS ARE BACK AND LOWER THAN EVER

Key Updates from the 2026 ACC/AHA/Multisociety Guidelines on the Management of Dyslipidemia1

The updated guideline outlines treatment sequencing with non-statin therapies, enabling earlier initiation of PCSK9i mAbs in select patient populations, including equal placement with ezetimibe*.

Goal: <70 mg/dL

+ ≥50% reduction from baseline

  • Primary prevention adults at high risk (Prevent-ASCVD 10-year risk ≥10%)
  • Adults with diabetes with multiple ASCVD risk factors
  • Secondary prevention ASCVD patients NOT at very high risk

Goal: <55 mg/dL

+ ≥50% reduction from baseline

  • Secondary prevention ASCVD patients at very high risk
  • Patients with severe hypercholesterolemia with clinical ASCVD

Endorsed by: ACC, American College of Cardiology; AHA, American Heart Association; AACVPR, American Association of Cardiovascular and Pulmonary Rehabilitation; ABC, Association of Black Cardiologists; ACPM, American College of Preventative Medicine; ADA, American Diabetes Association; AGS, American Geriatrics Society; APhA, American Pharmacists Association; ASPC, American Society for Preventative Cardiology; NLA, National Lipid Association; PCNA, Preventative Cardiovascular Nurses Association

*And in some cases, bempedoic acid

Adding a PCSK9i mAb is recommended to lower LDL-C as early as possible for patients with elevated Lp(a) and clinical ASCVD1

SEE HOW LDL-C GOALS VARY BY CAC LEVEL

When to Consider Adding a PCSK9i mAb for your patients with high LDL-C on maximally tolerated statin therapy1

Adults with Diabetes Aged 40-75 with Multiple ASCVD risk factors

Goal: LDL-C <70 mg/dL and ≥50% LDL-C reduction

Consider adding a PCSK9i mAb,
like evolocumab

or ezetimibe

Secondary ASCVD Prevention for Adults at Not Very High Risk

Goal: LDL-C <70 mg/dL and ≥50% LDL-C reduction
Optional Goal: LDL-C <55 mg/dL*

Consider adding a PCSK9i mAb,
like evolocumab

or ezetimibe

or bempedoic acid

Secondary ASCVD Prevention For Adults at Very High Risk†

Goal: LDL-C <55 mg/dL and ≥50% reduction

Consider adding a PCSK9i mAb,
like evolocumab

and/or ezetimibe

If goal still not achieved add bempedoic acid

*Based on clinical judgement and patient preference it is reasonable to treat patients with ASCVD not at very high risk to an LDL-C goal less than 55 mg/dL.

†ASCVD at very high risk is defined as ≥2 major ASCVD events (ACS within the past 12 months, history of MI [other than recent ACS], history of ischemic stroke, symptomatic PAD) or with 1 major ASCVD event and ≥2 high-risk features (age ≥65 years, coronary bypass or percutaneous intervention, current smoker, diabetes, history of heart failure [HF], hypertension, LDL-C ≥100 mg/dL [2.6 mmol/L] despite maximally tolerated statin plus ezetimibe).

An accompanying editorial authored by the ACC/AHA guideline chair and vice chair on behalf of the Guideline Writing Committee underscores the practice changing impact of the VESALIUS‑CV trial and signals that future guideline revisions may include lower LDL-C goals for these high-risk patients earlier in the ASCVD risk spectrum.2

CAC scores reveal hidden disease – act accordingly1

CAC scoring has a more prominent role as a risk enhancer in guiding treatment decisions in patients with subclinical atherosclerosis1

CAC above 0 with LDL-C above goal needs LDL-C lowering therapy

CAC Category (AU) LDL-C Goal Treatment Recommendations
CAC 1-99 AU and < 75th percentile for age, sex, race < 100 mg/dL Moderate-intensity statin therapy1
CAC 100-299 AU or ≥ 75th percentile for age, sex, race < 70 mg/dL Treatment with LDL-C-lowering therapies, with consideration of statin therapy as first-line1
CAC 300-999 AU < 70 mg/dL Treatment with LDL-C-lowering therapies, with consideration of statin therapy as first-line1
CAC 300-999 AU < 55 mg/dL intensified option Intensify therapy by increasing statin intensity or, if needed, adding a PCSK9i mAb, ezetimibe, or bempedoic acid1
CAC ≥ 1000 AU < 55 mg/dL Treatment with LDL-C-lowering therapies with consideration of statin therapy as first-line1

See how Repatha® can help your patients at increased risk of MACE lower their LDL-C— and their CV risk

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Efficacy in patients at high CV risk without MI or stroke

See how Repatha® can help your high-risk primary and secondary prevention patients lower their LDL-C—and their risk of MACE.
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Efficacy in patients with known ASCVD

See how Repatha® can help your secondary prevention patients lower their LDL-C—and their risk of MACE.
Cost-Effective IconCost-Effective Icon

Cost-Effective

The 2026 ACC/AHA/Multisociety Guideline states that PCSK9i mAbs, like Repatha®, are cost-effective.
GET INSIGHTS FROM YOUR PEERS
SEE THE EFFICACY OF REPATHA®
References: 1. Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia. JACC. Published online March 2026. 2. Blumenthal RS, Morris PB. Clinical Guidelines as a Continuous Work in Progress: Moving at the Speed of Science. JACC. 2026; In press.

Important Safety Information

Contraindication: Repatha® is contraindicated in patients with a history of a serious hypersensitivity reaction to evolocumab or any of the excipients in Repatha®. Serious hypersensitivity reactions including angioedema have occurred in patients treated with Repatha®.

Hypersensitivity Reactions: Hypersensitivity reactions, including angioedema, have been reported in patients treated with Repatha®. If signs or symptoms of serious hypersensitivity reactions occur, discontinue treatment with Repatha®, treat according to the standard of care, and monitor until signs and symptoms resolve.

Adverse Reactions in Primary Hypercholesterolemia: The most common adverse reactions (>5% of patients treated with Repatha® and more frequently than placebo) were: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions.

From a pool of the 52-week trial and seven 12‑week trials: Local injection site reactions occurred in 3.2% and 3.0% of Repatha®-treated and placebo-treated patients, respectively. The most common injection site reactions were erythema, pain, and bruising. Hypersensitivity reactions occurred in 5.1% and 4.7% of Repatha®-treated and placebo-treated patients, respectively. The most common hypersensitivity reactions were rash (1.0% versus 0.5% for Repatha® and placebo, respectively), eczema (0.4% versus 0.2%), erythema (0.4% versus 0.2%), and urticaria (0.4% versus 0.1%).

Adverse Reactions in the FOURIER Cardiovascular Outcomes Trial: The most common adverse reactions (>5% of patients treated with Repatha® and more frequently than placebo) were: diabetes mellitus (8.8% Repatha®, 8.2% placebo), nasopharyngitis (7.8% Repatha®, 7.4% placebo), and upper respiratory tract infection (5.1% Repatha®, 4.8% placebo).

Among the 16,676 patients without diabetes mellitus at baseline, the incidence of new-onset diabetes mellitus during the trial was 8.1% in patients treated with Repatha® compared with 7.7% in patients that received placebo.

Immunogenicity: Repatha® is a human monoclonal antibody. As with all therapeutic proteins, there is potential for immunogenicity with Repatha®.

Indications

Repatha® is indicated:

  • To reduce the risk of major adverse cardiovascular (CV) events (CV death, myocardial infarction, stroke, unstable angina requiring hospitalization, or coronary revascularization) in adults at increased risk for these events.
  • As an adjunct to diet and exercise to reduce low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia and in adults with heterozygous familial hypercholesterolemia (HeFH)

Please see full Prescribing Information.

Important Safety Information

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