Last reviewed 2026-04-20 · How we verify

Evkeeza (EVINACUMAB)

Evkeeza works by blocking the action of Angiopoietin-related protein 3, a protein that helps regulate cholesterol levels in the blood.

Evkeeza (EVINACUMAB) is a small molecule Angiopoietin-like 3 Inhibitor developed by Regeneron Pharmaceuticals. It targets Angiopoietin-related protein 3 to treat Homozygous Familial Hypercholesterolemia. Evkeeza was FDA-approved in 2021 and is currently owned by Regeneron Pharmaceuticals. As a patented medication, it is not yet available as a generic. Key safety considerations include the need for careful monitoring of patients with a history of thrombotic events.

At a glance

Mechanism of action

Evinacumab-dgnb is recombinant human monoclonal antibody that binds to and inhibits ANGPTL3. ANGPTL3 is member of the angiopoietin-like protein family that is expressed primarily in the liver and plays role in the regulation of lipid metabolism by inhibiting lipoprotein lipase (LPL) and endothelial lipase (EL). Evinacumab-dgnb inhibition of ANGPTL3 leads to reduction in LDL-C, HDL-C, and triglycerides (TG). Evinacumab-dgnb reduces LDL-C independent of the presence of LDL receptor (LDLR) by promoting very low-density lipoprotein (VLDL) processing and clearance upstream of LDL formation. Evinacumab-dgnb blockade of ANGPTL3 lowers TG and HDL-C by rescuing LPL and EL activities, respectively.

Approved indications

• Homozygous familial hypercholesterolemia

Common side effects

• Nasopharyngitis
• Influenza like illness
• Dizziness
• Rhinorrhea
• Nausea
• Pain in extremity
• Asthenia
• Infusion site pruritus
• Pyrexia
• Muscular weakness
• Nasal congestion
• Constipation

Key clinical trials

• Study to Assess the Effects of Angiopoietin-like Protein 3 (ANGPTL3) Inhibition in Adult Participants With Diabetic Kidney Disease (PHASE2)
• Assessing the Impact of Intensification of Lipid Lowering Therapy With Guidelines-based Evinacumab Administration on Coronary Plaque Volumes Measured by Coronary Computed Tomography Angiography (CCTA) in Patients With Homozygous Familial Hypercholesterolemia (HoFH)
• Compassionate Use of Evinacumab
• Evaluate the Long-Term Safety and Efficacy of Evinacumab in Patients With Homozygous Familial Hypercholesterolemia (PHASE3)
• Safety and Effectiveness of Evinacumab for the Treatment of Homozygous Familial Hypercholesterolemia (PHASE3)
• Evaluate the Efficacy and Safety of Evinacumab in Pediatric Patients With Homozygous Familial Hypercholesterolemia (PHASE3)
• Efficacy and Safety of Evinacumab in Adult Patients With Severe Hypertriglyceridemia for the Prevention of Recurrent Acute Pancreatitis (PHASE2)
• Safety and Efficacy Following Repeat-Dose of Evinacumab (Anti-ANGPTL3) in Patients With Severe Hypertriglyceridemia (sHTG) at Risk for Acute Pancreatitis (PHASE2)

Patents

Primary sources

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