[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [ANGPTL3 inhibitors](https://durgical.com/en/pharmacology/classes/angptl3-inhibitors/) › Evinacumab # Evinacumab ## ANGPTL3 inhibitors? ANGPTL3 inhibitors ## Pregnancy: avoid? Avoided in pregnancy: it may harm the fetus, so a pregnancy test may be done and effective contraception is used during treatment and for months after the last dose. A monoclonal antibody against ANGPTL3 that lowers LDL cholesterol even without LDL receptors. Monthly infusion for homozygous familial hypercholesterolaemia. Updated Nov 12, 2026 ## Quick facts **Group** [ANGPTL3 inhibitors](https://durgical.com/en/pharmacology/classes/angptl3-inhibitors/) **Target** Angiopoietin-like protein 3 (ANGPTL3), a circulating inhibitor of lipoprotein and endothelial lipases **Key effects** Runny or stuffy nose · Dizziness **Monitor** LDL cholesterol and lipid profile **ATC** C10AX17 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◆**Angiopoietin-like protein 3 (ANGPTL3), a circulating inhibitor of lipoprotein and endothelial lipases**Evinacumab ⓘ The figure shows the fibrinogen-like domain of human ANGPTL3; the antibody itself is not in this structure. **Target in 3D:** Angiopoietin-like protein 3 (ANGPTL3), a circulating inhibitor of lipoprotein and endothelial lipases. PDB structure 6EUA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6EUA) · Drag to rotate · pinch to zoom ANGPTL3, made in the liver, inhibits lipoprotein lipase and endothelial lipase. Evinacumab is a fully human monoclonal antibody that binds and neutralises ANGPTL3. The lipases become more active, so triglyceride-rich lipoproteins are broken down faster and fewer remnants become LDL; LDL cholesterol falls by a pathway that does not need LDL receptors. That is why it works in homozygous familial hypercholesterolaemia, where LDL receptors are absent or barely work. - Antibody binds and neutralises ANGPTL3 - Lipoprotein and endothelial lipases are released from inhibition - Triglyceride-rich particles are cleared; less LDL forms - LDL falls without needing LDL receptors ## Indications - Homozygous familial hypercholesterolaemia, added to other lipid-lowering treatment [Familial hypercholesterolemia →](https://durgical.com/en/conditions/familial-hypercholesterolemia/) ## Adverse effects ### Common - Runny or stuffy nose, sore throat, flu-like symptoms - Dizziness, nausea - Pain in arms or legs - Tiredness or weakness ### Serious (rare, important) - Serious allergic reactions, including anaphylaxis - Infusion reactions (itching, fever, muscle weakness, nasal congestion) ## Contraindications - History of serious hypersensitivity to evinacumab ## Key interactions **Other lipid-lowering drugs (statins, ezetimibe, PCSK9 inhibitors, apheresis)** Used together as background therapy. ## What is monitored - LDL cholesterol and lipid profile - Infusion and allergic reactions - Pregnancy test before starting when relevant ## Administration and safety - Slow intravenous infusion in a health-care setting every four weeks. - The infusion is slowed or stopped for an infusion reaction. - A low-fat, low-cholesterol diet and other lipid-lowering treatment continue. ## Pregnancy and breastfeeding Avoided in pregnancy: it may harm the fetus, so a pregnancy test may be done and effective contraception is used during treatment and for months after the last dose. ## Nursing care - Before: check allergies, baseline lipids and pregnancy status. - During: watch for itching, rash, swelling or breathing difficulty. - Teach to report symptoms of an allergic reaction after the infusion. - Remind about missed infusions and diet. ## Pharmacokinetics **Absorption** Intravenous infusion over about an hour, every four weeks. ## Memory aid EVINACUMAB lifts the brake on lipases: Anti-ANGPTL3, Any LDL receptor not required. ## Test yourself Think of the answer, then tap the question to see it. ## What does ANGPTL3 normally do? It inhibits lipoprotein lipase and endothelial lipase. ## Why does evinacumab work in homozygous FH when statins barely do? It lowers LDL by a pathway that does not depend on LDL receptors. ## How is evinacumab given? As an intravenous infusion every four weeks. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/evinacumab/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **Pregnancy: avoid** Avoided in pregnancy: it may harm the fetus, so a pregnancy test may be done and effective contraception is used during treatment and for months after the last dose. ## Connections ## Related drugs 4 - [Lomitapide](https://durgical.com/en/pharmacology/lomitapide/) - [Evolocumab](https://durgical.com/en/pharmacology/evolocumab/) - [Atorvastatin](https://durgical.com/en/pharmacology/atorvastatin/) - [Ezetimibe](https://durgical.com/en/pharmacology/ezetimibe/) ## Related conditions 1 - [Familial hypercholesterolemia](https://durgical.com/en/conditions/familial-hypercholesterolemia/) [← Back to the class: ANGPTL3 inhibitors](https://durgical.com/en/pharmacology/classes/angptl3-inhibitors/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Evinacumab-dgnb Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a621023.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [The fibrinogen-like domain of human Angptl3](https://www.rcsb.org/structure/6EUA) (RCSB Protein Data Bank, 2018); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C10AX17) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/evinacumab/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/evinacumab/