4CPS-022 PCSK9 inhibitors: evaluation of effectiveness in our centre in relation to the official clinical endpoints

Abstract

Aim and objectives To evaluate the effectiveness of alirocumab and evolocumab in reducing low density lipoprotein cholesterol (LDL-c) and RCE in patients with poorly controlled hyperlipidaemia. Material and methods This was an observational and retrospective study which included every patient treated with alirocumab and evolocumab between March 2016 and September 2019. Demographics and clinical variables were collected from the electronic medical records: sex, age, drug, dose, frequency of administration, previous hypolipaemic treatment, causes of suspension and analytical parameters at the start of treatment, and after 12 weeks and 24 weeks (total cholesterol (TC), LDL-c, high density lipoprotein (HDL)-cholesterol and triglycerides). To assess RCE, the Framingham scale was used, and if patients were diabetic or smokers was also recorded. To assess effectiveness, we calculated the percentage reduction (PR) of TC, LDL-c and RCE. Adverse effects (AE) were recorded to assess safety. Results Forty-six patients were included (76% men, average age 60.8 (SD 11.1) years: 24 were treated with alirocumab and 22 with evolocumab. Median duration of treatment was 27.2 months (0.2-43.8). At drug initiation, 71.7% of patients were on high dose statins and 76.1% were on ezetimibe as an adjuvant. Six patients discontinued treatment: 4 for toxicity, 1 for associated pathology and 1 due to loss of follow up.