Journal
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
Volume 71, Issue 11, Pages -Publisher
WILEY
DOI: 10.1111/ijcp.13032
Keywords
-
Ask authors/readers for more resources
BackgroundPrescribing criteria have been suggested for proprotein convertase subtilisin kexin-9 (PCSK-9) inhibitors but few studies exist of their real-world effectiveness. MethodsThis study audited PCSK-9 inhibitor therapy in 105 consecutive patients from two hospital centres-a university hospital (UH; n=70) and a district general hospital (DGH; n=35). Baseline characteristics including cardiovascular disease risk factors, NICE qualification criteria, efficacy and side effects were assessed. ResultsBaseline LDL-C levels were similar in both centres. NICE criteria were met for 2.05 items in the whole study (UH patients 1.7 and DGH patients 2.7). District general hospital patients were more likely to have familial hypercholesterolaemia (89 vs 69%; P=.02); intolerance to statins (94 vs 52%; P<.001) and polyvascular disease (42% vs 17%; P=.005). Prescriptions (evolocumab 73%; alirocumab 23%) were collected by 76% of patients (UH 64% vs DGH 100%). Therapy was discontinued by time of review in 15% of patients (UH 7% vs DGH 25%; P=.02). In adherent patients PCSK-9 inhibitor treatment reduced TC by 28% (2.242.39mmol/L; P<.001) and LDL-C by 49% (2.10 +/- 1.33mmol/L; P<.001). A LDL-C<2.5mmol/L was achieved in 30% of patients and <2.0mmol/L in 20%. PCSK-9 therapy was effective and safe in patients with increased lipoprotein (a), diagnosed muscle diseases (including myopathies and muscular dystrophy) or poststatin rhabdomyolysis, nephrotic syndrome or HIV disease. Mixed results were obtained in patients with significant mixed hyperlipidaemia. ConclusionsThis study suggests that PCSK-9 inhibitors are effective but that prescriptions should not be changed to long-term delivery until patients have been reviewed and shown to be adherent.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available