How Does Repatha (Evolocumab) Work to Lower Cholesterol?

Added: 2026-06-02

[00:00:00]Cholesterol-lowering medication is important for a lot of individuals. So, you'll have to let us know in the comments what treatments you're familiar with. But for today's video, I want to break down a biologic treatment that's known as Rapatha. This is a monoconal antibbody with the name of Evolakumab, and it's used to decrease LDL cholesterol or low density lipoprotein, sometimes referred to as bad cholesterol. This helps in decreasing the risks of heart attacks, stroke and other heart diseases. And rapatha is given via a self- injection either through a syringe or an auto injector or can use a very specific wearable device for delivery of this medication. And it's given two times per month or every 2 weeks. And the way that it works is that if we zoom in within the liver on liver cells, there's specific receptors called LDL receptors. And those are responsible for binding to LDL and pulling it out of the bloodstream.

[00:01:02]Therefore, decreasing the amount of circulating LDL or bad cholesterol.

[00:01:07]However, our bodies also produce another protein called PCSK9.

[00:01:12]And this protein is also able to bind to those LDL receptors, have them internalized, and then destroyed.

[00:01:19]Therefore, they're not able to bind to that LDL in the blood. So LDL continues to circulate in the blood and those levels rise. But when one is treated with Rapatha, Rapatha is a monoconal antibbody specific for binding to PCSK9.

[00:01:36]Therefore, when it binds to that protein, that protein does not bind to the LDL receptors, allowing those LDL receptors to do their job, bind to LDL, and then decrease LDL in the blood. You can almost think of this whole process like you're trying to cast a net to catch fish in the river. The net is the LDL receptors and the fish that you're looking to catch are LDL. However, sometimes that river gets contaminated with trash and that trash clogs up your net before you can catch fish. And that trash is PCSK9.

[00:02:12]However, Rapatha can come in and those are cleaners that can help clean up that trash before it reaches your net. So therefore, you can still catch your fish. So let us know in the comments what drugs you're familiar with in order to decrease LDL cholesterol and stay connected to my channel and with Dan Garvin for more scientific lessons.

[00:02:33]Thank you for watching my latest video.

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