Lipid-lowering effect of evolocumab in hypertriglyceridemia-induced acute pancreatitis

Background

The primary goal of treatment for hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is to rapidly reduce blood triglyceride (TG) level to below 5.65 mmol/L. Evolocumab with a significant lipid-lowering effect, has been widely used for cardiovascular diseases. However, it has been rarely explored in HTG-AP.

Methods

HTG-AP patients, who were admitted between January 2022 and February 2024, were retrospectively reviewed. They were further divided according to the use of evolocumab. Blood TG levels before treatment were compared with those after 1–2 days, 3–4 days, and 5–7 days of treatment.

Results

Overall, 62 patients were included, of whom 30 (48.4 %) were in the evolocumab group and 32 (51.6 %) were in the non-evolocumab group. The median pre-treatment TG levels were not significantly different between them (22.17 mmol/L vs 16.94 mmol/L, P = 0.108). Blood TG levels after 1–2 days (P = 0.016) and 5–7 days (P = 0.007) were significantly higher in the evolocumab group than the non-evolocumab group. The proportion of TG < 5.65 mmol/L after 1–2 days (6/24 vs 11/23, P = 0.104) and 3–4 days (10/19 vs 14/20, P = 0.265) was not significantly different between them, but that after 5–7 days (9/15 vs 19/20, P = 0.033) was significantly lower in the evolocumab group than the non-evolocumab group.

Conclusion

The addition of evolocumab to conventional lipid-lowering therapy did not produce any additional benefit in the reduction of blood TG levels in HTG-AP patients.