Sex Differences in Low-Density Lipoprotein Cholesterol Reduction With PCSK9 Inhibitors in Real-world Patients: The LIPID-REAL Registry. Issue 4 (April 2022)

• Record Type: Journal Article
• Authors: Cordero, Alberto; Fernández del Olmo, M. Rosa; Cortez Quiroga, Gustavo A.; Romero-Menor, Cesar; Fácila, Lorenzo; Seijas-Amigo, José; Fornovi, Aisa; Murillo, Juan R.; Rodríguez-Mañero, Moisés; Bello Mora, María C.; Valle, Alfonso; Miriam, Sandin; Pamias, Roman F.; Bañeras, Jordi; García, Pedro B.; Clemente Lorenzo, Maria M.; Sánchez-Alvarez, Sergio; López-Rodríguez, Luis; González-Juanatey, José R.
• Is Part Of: Journal of cardiovascular pharmacology. Volume 79:Issue 4(2022)
• Page Start: 523
• Page End: 529
• Publication Date: 2022-04
• Subjects: PCSK9 inhibitors -- evolocumab -- alirocumab -- LDLc; Cardiovascular Diseases -- drug therapy -- Periodicals; Cardiovascular System -- drug effects -- Periodicals; Cardiovascular pharmacology -- Periodicals; Cardiovascular agents -- Periodicals; Cardiovascular agents; Cardiovascular pharmacology; Periodicals; 615.7105
• DOI: 10.1097/FJC.0000000000001205
• Languages: English
• ISSNs: 0160-2446

Abstract

Abstract : Background: Previous evidence supports that monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 50%–65%, regardless of baseline treatments. We tested possible sex differences in a multicentre registry of real-world patients treated with PCSK9 inhibitors. Methods: This is a multicentre and retrospective study of 652 patients initiating treatment with any PCSK9 inhibitor in 18 different hospitals. Before-treatment and on-treatment LDLc and medical treatments, clinical indication, and clinical features were recorded. Results: Women represented 24.69% of the cohort. The use of statins was similar in both sexes, but women were receiving most frequently ezetimibe. Before-treatment median LDLc was 135 (interquartile range 115–166) mg, and it was higher in women. The median on-treatment LDLc was 57 (interquartile range 38–84) mg/dL, which represented a mean 54.5% reduction. On-treatment LDLc was higher in women, and the mean LDLc reduction was lower in women (47.4% vs. 56.9%; P = 0.0002) receiving evolocumab or alirocumab. The percentage of patients who achieved ≥50% LDLc reduction was higher in men (71.36% vs. 57.62%; P = 0.002). According to LDLc before-treatment quartiles, LDLc reduction was statistically lower in women in the 2 highest and a significant interaction of women and baseline LDLc >135 mg/dL was observed. Women were negatively associated with lower rates of LDLc treatment target achievement (odds ratio: 0.31). Differences were also observed in women with body mas index >25 kg/m 2 . Only 14 patients (2.14%) presented side effects. Conclusions: This multicentre and retrospective registry of real-world patients treated with PCSK9 inhibitors highlights significant gender differences in LDLc reduction.