Clinical Edge

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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.

Citation:

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.