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Evinacumab is a fully human monoclonal antibody that targets angiopoietin-like protein 3 (ANGPTL3). It is used as an adjunct to other lipid-lowering therapies for the treatment of homozygous familial hypercholesterolemia (HoFH) in adults and children aged 5 years and older. Evinacumab works by binding to and inhibiting ANGPTL3, a protein that normally inhibits enzymes involved in lipid metabolism such as lipoprotein lipase (LPL) and endothelial lipase (EL). By blocking ANGPTL3, evinacumab increases the activity of these enzymes, leading to enhanced breakdown of triglycerides and phospholipids, increased clearance of apoB-containing lipoproteins from circulation, and reduced levels of LDL cholesterol. This mechanism is independent of LDL receptor function, making it effective even in patients with minimal or absent LDL receptor activity. Evinacumab was developed by Regeneron Pharmaceuticals and is marketed under the brand name Evkeeza[1][2][5][7][8].
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