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How does Repatha work?

Medically reviewed by Last updated on Apr 14, 2019.

Official Answer


Repatha (evolocumab) is a human monoclonal antibody that works by helping the liver reduce levels of "bad" cholesterol (low-density lipoprotein, or LDL) circulating in your blood.

Repatha is the second PCSK9 inhibitor to be approved by the FDA; the first was Praluent (alirocumab). PCSK9 inhibitors are a new medication class that has been shown to greatly lower LDL (bad) cholesterol levels. PCSK9 inhibitors are known as monoclonal antibodies (MABs), a type of biologic drug. They work by inactivating a protein in the liver called proprotein convertase subtilisin kexin 9 (PCSK9). PCSK9 itself inactivates the needed receptors on the liver cell surface that transport LDL into the liver for metabolism (break down). Without these receptors, more LDL (bad cholesterol) remains in the blood. So, by inactivating PCSK9, more receptors are available to capture the bad LDL cholesterol for breakdown and removal from the blood.

Lowering the LDL in the blood is better for the heart.

See Also: PCSK9 Inhibitors: A New Class of Cholesterol Busters

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