Alirocumab
PCSK9 inhibitor — monoclonal antibody · “The post-ACS injectable”
The Clinical Case
Female, 61 yo. STEMI 8 weeks ago, successfully stented. On atorvastatin 80 mg + ezetimibe. LDL 2.8 mmol/L (target <1.4). Cardiologist initiates a PCSK9 mAb, citing the ODYSSEY OUTCOMES trial — the only PCSK9 antibody trial to show a signal for all-cause mortality reduction, specifically in post-ACS patients with LDL ≥2.6 at baseline. Dose self-titrates if LDL not at goal.
The Answer
Played on: 12 Jan 2026 · 26 Jan 2026 · 9 Feb 2026 · 23 Feb 2026 · 9 Mar 2026 · 23 Mar 2026 · 6 Apr 2026 · 20 Apr 2026 · 4 May 2026 · 18 May 2026 · 1 Jun 2026 · 15 Jun 2026 · 29 Jun 2026 · 13 Jul 2026 · 27 Jul 2026 · 10 Aug 2026 · 24 Aug 2026
Clinical Pearl
Mechanism: Human IgG1 mAb vs PCSK9; same receptor-recycling mechanism; LDL↓ 46–67% on top of maximally tolerated statin
All Hints
Mechanism: Human IgG1 mAb vs PCSK9; same receptor-recycling mechanism; LDL↓ 46–67% on top of maximally tolerated statin
ODYSSEY: ODYSSEY OUTCOMES: post-ACS → 15% RRR MACE + all-cause mortality reduction signal in high-LDL subgroup
Mortality: Only PCSK9 mAb with mortality signal (post-hoc analysis, high-risk subgroup) — drives preference in post-ACS
Dosing: 75 mg SC q2w; escalate to 150 mg q2w if LDL not at target after 4–8 weeks — auto-titration design
vs Evolocumab: Similar efficacy and safety; choice driven by formulary, cost, or post-ACS clinical context
Think you can beat today's puzzle?
A new clinical case every day. 6 guesses to name the drug.
Play today's Med Wordle — #240 →