Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:1010-7 - Vol. 71 Num.12 DOI: 10.1016/j.rec.2018.03.003

Number of Patients Eligible for PCSK9 Inhibitors Based on Real-world Data From 2.5 Million Patients

Alberto Zamora a,b,c, Luís Masana b,d, Marc Comas-Cufi e,f, Núria Plana b,d, Àlex Vila g, Maria García-Gil e,f, Lia Alves-Cabratosa e,f, Roberto Elosua h,i, Jaume Marrugat h,i, Rafel Ramos a,e,f,

a Laboratorio de Medicina Traslacional, Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Girona, Girona, Spain
b Xarxa d’Unitats de Lípids de Catalunya (XULA), Girona, Spain
c Unidad de Lípidos, Hospital de Blanes, Blanes, Girona, Spain
d Unidad de Lípidos y Arteriosclerosis, Departamento de Medicina Interna, Hospital Universitario San Joan de Reus, Institut d’Investigació Sanitària Pere Virgili (IISPV), Universidad Rovira i Virgili, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Reus, Tarragona, Spain
e Grup Investigació en Salut Cardiovascular de Girona (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
f Institut d’Investigació Biomèdica de Girona (IdIBGi), Institut Català de la Salut (ICS), Girona, Spain
g Unidad de Lípidos y Arteriosclerosis, Hospital de Figueres, Figueras, Girona, Spain
h Registre Gironí del Cor (REGICOR), Grupo de Investigación en Epidemiología y Genética Cardiovascular (EGEC), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
i Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain

Refers to

Keywords

PCSK9 inhibitors. Alirocumab/evolocumab. Low-density lipoprotein cholesterol. Therapeutic indication.

Abstract

Introduction and objectives

PCSK9 inhibitors (PCSK9i) are safe and effective lipid-lowering drugs. Their main limitation is their high cost. The aim of this study was to estimate the number of patients eligible for treatment with PCSK9i according to distinct published criteria.

Methods

Data were obtained from the Information System for the Development of Research in Primary Care. Included patients were equal to or older than 18 years and had at least 1 low-density lipoprotein cholesterol measurement recorded between 2006 and 2014 (n = 2 500 907). An indication for treatment with PCSK9i was assigned according to the following guidelines: National Health System, Spanish Society of Arteriosclerosis, Spanish Society of Cardiology, National Institute for Health and Care Excellence, and the European Society of Cardiology/European Atherosclerosis Society Task Force. Lipid-lowering treatment was defined as optimized if it reduced low-density lipoprotein levels by ≥ 50% and adherence was > 80%.

Results

Among the Spanish population aged 18 years or older, the number of possible candidates to receive PCSK9i in an optimal lipid-lowering treatment scenario ranged from 0.1% to 1.7%, depending on the guideline considered. The subgroup of patients with the highest proportion of potential candidates consisted of patients with familial hypercholesterolemia, and the subgroup with the highest absolute number consisted of patients in secondary cardiovascular prevention.

Conclusions

The number of candidates to receive PCSK9i in conditions of real-world clinical practice is high and varies widely depending on the recommendations of distinct scientific societies.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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