Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Treatment Patterns of PCSK9 Inhibitors

Am J Cardiovasc Drugs; ePub 2017 Aug 28; Rane, et al

Patients treated with proprotein convertase subtilisin/kexin 9 inhibitors (PCSK9i) had higher rates of cardiovascular comorbidities and physician-determined statin intolerance, had higher low-density lipoprotein cholesterol (LDL-C) levels, and received more lines of therapy than non-PCSK9i patients, a new study found. 159 surveyed physicians provided treatment history, lab values, patient characteristics, and comorbidities for 1,522 treated patients (n=304 PCSK9i; n=1,218 non-PCSK9i). Researchers analyzed data from a point-in-time Adelphi dyslipidemia disease-specific program (DSP) survey in the US in 2016. They found:

  • Physicians surveyed appeared to prescribe PCSK9 inhibitor medications appropriately.
  • Mean (SD) baseline LDL-C levels were 180.0 ±39.7 mg/dl for PCSK9i patients and 159.2 ±40.5 mg/dl for non-PCSK9i patients.
  • Prior statin use was reported in ~69% of PCSK9i patients and 19.5% of non-PSCK9i patients; statin intolerance was observed in 31.6% of PCSK9i and 5.3% of non-PCSK9i patients.
  • Use of statin only was reported in 40.5% of PCSK9i and 88.8% of non-PCSK9i patients.
  • The most common physician-reported reasons for change to PCSK9i were lack of efficacy (70.2%) and muscle-related symptoms.

Rane PB, Patel J, Harrison DJ, et al. Patient characteristics and real-world treatment patterns among early users of PCSK9 inhibitors. [Published online ahead of print August 28, 2017]. Am J Cardiovasc Drugs. doi:10.1007/s40256-017-0246-z.

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