Clinical characteristics and lipid lowering treatment of patients initiated on proprotein convertase subtilisin-kexin type 9 inhibitors: a nationwide cohort study. Issue 4 (1st April 2019)

• Record Type: Journal Article
• Authors: Jensen, Jakob Solgaard; Weeke, Peter Ejvin; Bang, Lia Evi; Høfsten, Dan Eik; Ripa, Maria Sejersten; Schjerning, Anne-Marie; Theilade, Juliane Elizabeth; Køber, Lars Valeur; Gislason, Gunnar Hilmar; Pallisgaard, Jannik
• Is Part Of: BMJ open. Volume 9:Issue 4(2019)
• Publication Date: 2019-04-01
• Subjects: proprotein convertase subtilisin–kexin type 9 inhibitor -- lipid lowering treatment -- cardiovascular disease -- descriptive cohort; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-022702
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Given the novelty of proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i), little is known regarding overall implementation or clinical characteristics among patients who initiate treatment. We aimed to assess the total number of patients initiated on PCSK9i along with a description of the clinical characteristics and lipid lowering treatment (LLT) of such patients. Setting: A register-based descriptive cohort study of patients receiving a PCSK9i in the time period from 01 January 2016 to 31 March 2017 using a cross linkage between three nationwide Danish registers. Information regarding PCSK9i prescriptions, patient demographics, concurrent pharmacotherapy, comorbidities and previous coronary procedures was identified. Results: Overall, 137 patients initiated treatment with PCSK9i in the study period from 11 in the first quarter of 2016 to 40 in the first quarter of 2017. The majority had a history of ischaemic heart disease (IHD) (67.9%) with ischaemic stroke and diabetes mellitus being present in 7.3% and 16.8% of patients, respectively. All patients initiated on PCSK9i had been previously prescribed statin treatment with atorvastatin and simvastatin being most frequently prescribed in 53% and 36% of patients, respectively. The majority of patients had received both statins and ezetimibe (94.9%) and approximately half of these patients had also received bile acid sequestrant (45.3%). Clinical characteristics mainly differed in patients receiving triple LLT compared with patients not receiving triple LLT in the regards of heart failure. Conclusion: Patients treated with PCSK9i were rare, characterised by having IHD and had received various and intensive conventional LLT prior to PCSK9i initiation in agreement with current international guidelines.