Baseline characteristics and response to evinacumab in females and males with homozygous familial hypercholesterolemia in the ELIPSE OLE study

Aim: Evinacumab is an ANGPTL-3 inhibitor developed for the treatment of homozygous familial hypercholesterolemia (HoFH), a rare condition characterized by extremely elevated LDL-cholesterol (LDL-C) levels and premature atherosclerotic cardiovascular disease. Despite important sex-related disparities in lipid metabolism, females are still underrepresented in trials, limiting the generalizability of results. With 116 patients, of which 49 % were females, the ELIPSE-OLE study has the largest cohort of HoFH females involved in a clinical trial. The aim of this analysis was to compare response to evinacumab in females and males in the ELIPSE OLE study. Methods: This study is a post hoc exploratory analysis of data on 57 females and 59 males, aged ≥12 years and on stable background lipid-lowering therapy (LLT) from ELIPSE OLE. Patients received evinacumab 15 mg/kg intravenously every 4 weeks. The primary efficacy endpoint was the reduction in LDL-C concentration from baseline to week-24. Results: Baseline LDL-C [mean (SD)] tended to be higher in females aged 18 to