Rankings / Metabolic Health

Evinacumab / Zodasiran (ANGPTL3 inhibitors)

Metabolic Health · ANGPTL3 inhibitor (mAb / RNAi)

Tier B

Reviewed by Read Off Label · Last reviewed · How we grade

angptl3rna-therapymonoclonal-antibodydyslipidemiainvestigationalprescription
6.6 / 10
Tier B
Ev 8 Bn 6.5 Sf 5

Bottom line

Read Off Label grades Evinacumab / Zodasiran (ANGPTL3 inhibitors) as B (6.6/10) based on strong evidence, med-high benefit magnitude, and a med-risk safety profile.

Evinacumab (Regeneron) approved for homozygous familial hypercholesterolemia.

Typical use: Evinacumab IV every 4 weeks; zodasiran SC — Rx (evinacumab approved for HoFH as Evkeeza); zodasiran investigational.

What this is

Evinacumab (Regeneron) approved for homozygous familial hypercholesterolemia. Zodasiran (Arrowhead) RNAi: ARCHES-2 Phase 2b (NEJM 2024) showed deep TG/LDL/ANGPTL3 reductions; GATEWAY Phase 2 in HoFH sustained LDL -46% at 21 months; Phase 3 YOSEMITE began dosing 2025. LDL pathway distinct from PCSK9. Industry-sponsored.

Mechanism

ANGPTL3 inhibition (evinacumab = monoclonal antibody; zodasiran = RNAi) lowers LDL-C, triglycerides and HDL via a pathway independent of the LDL receptor, effective even in receptor-negative homozygous FH.

Dose & route

Evinacumab IV every 4 weeks; zodasiran SC

Citations

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Common questions

Does Evinacumab / Zodasiran (ANGPTL3 inhibitors) work?
Read Off Label rates the evidence for Evinacumab / Zodasiran (ANGPTL3 inhibitors) as Strong and the benefit magnitude as med-high, producing an overall grade of B (6.6/10). Evinacumab (Regeneron) approved for homozygous familial hypercholesterolemia.
Is Evinacumab / Zodasiran (ANGPTL3 inhibitors) safe?
Evinacumab / Zodasiran (ANGPTL3 inhibitors) has a med risk profile in published human data. Legal status: Rx (evinacumab approved for HoFH as Evkeeza); zodasiran investigational (Phase 3). This is not medical advice — see the disclaimer.
What is the typical dose for Evinacumab / Zodasiran (ANGPTL3 inhibitors)?
Evinacumab IV every 4 weeks; zodasiran SC
How does Evinacumab / Zodasiran (ANGPTL3 inhibitors) work?
ANGPTL3 inhibition (evinacumab = monoclonal antibody; zodasiran = RNAi) lowers LDL-C, triglycerides and HDL via a pathway independent of the LDL receptor, effective even in receptor-negative homozygous FH.

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.