Clinical Edge

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

PCSK9 Inhibitor Use in Real World Settings

Among a large cohort of patients with cardiovascular (CV) risk, about half had been prescribed lipid-lowering medication, but <1% were prescribed proprotein convertase subtilisin/kexin (PCSK9) inhibitors. Researchers obtained data from 18 health systems with data marts within the National Patient-Centered Clinical Research Network (PCORnet) suing a common data model. Participants sites identified >17.5 million adults, of whom 3.6 million met study criteria. Patients (mean age 62 years, 50% female, 11% black) were categorized into 3 groups: dyslipidemia, untreated low-density lipoprotein (LDL) ≥130 mg/dL, and coronary artery disease (CAD) or coronary heart disease (CHD). Demographics, comorbidities, estimated 10-year atherosclerotic CVD risk, and lipid-lowering pharmacotherapies were summarized for each group. Among the findings:

  • LDL-C ranged from 85 md/dL to 151 mg/dL.
  • Among patients in groups 1 and 3, 54% received standard lipid-lowering therapies and a PCSK9 inhibitor was prescribed in <1% of patients.
  • PCSK9 inhibitor prescribing increased over time for patients with CAD or CHD but not for those with dyslipidemia.


Chamberlain AM, Gong Y, Shaw KM, et al. PCSK9 inhibitor use in the real world : Data from the National Patient-Centered Research Network. J Am Heart Assoc. [Published online ahead of print May 7, 2019]. doi:10.1161/JAHA.118.011246.