Evolocumab (trade name Repatha) is a PCSK9 inhibitor used for patients with elevated cholesterol who require significant LDL reduction beyond what statins and other medications can provide. It works by blocking the PCSK9 protein, which increases the number of LDL receptors on the liver, allowing more LDL (“bad” cholesterol) to be removed from the blood. Administered as a subcutaneous injection every 2–4 weeks, evolocumab can lower LDL cholesterol by up to 60%. It is especially useful in patients with familial hypercholesterolemia or those with atherosclerotic cardiovascular disease who remain at high risk despite maximally tolerated statin therapy.