{
  "abstract": "Background and Importance Maintaining a calculated level of LDL cholesterol (cLDL) below 70 mg/dL is a minimum goal in patients at high cardiovascular risk to reduce the likelihood of further events. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), such as alirocumab and evolocumab, effectively manage cLDL levels. However, the relative efficacy of combining these drugs with other lipid-lowering therapies is less well-known.Aim and Objectives This study aims to describe cLDL control in patients treated with PCSK9i for the prevention of secondary cardiovascular events or strokes and to evaluate the impact of adjunctive lipid-lowering therapy on cLDL levels.Material and Methods A cross-sectional study was conducted among patients receiving evolocumab or alirocumab. We recorded age, sex, cLDL level, the use of additional lipid-lowering therapy, and adherence to it (defined as dispensing 80% of planned packages). Eligible patients included those on active secondary prevention treatments, with cLDL measurements taken at least two months post-PCSK9i initiation. Patients with cLDL <10 mg/dl or >200 mg/dl were excluded. Participants were categorised into four groups based on their added lipid-lowering treatments: no added therapy, high-efficacy statin (atorvastatin/rosuvastatin) and ezetimibe, high-efficacy statin alone, and ezetimibe alone. Patients with poor adherence were assigned to the no added therapy group. We used the Kruskal-Wallis and Fisher tests to compare mean cLDL levels and the proportion of patients achieving cLDL<70 mg/dl, respectively.Results Among 138 analysed patients (31% women, mean age 65.8±10.9 years), 71% of cases had cLDL<70 mg/dl and mean cLDL levels were 57.1±22.7 mg/dl; these levels varied significantly among groups: 48.4±16.3 mg/dl for statin plus ezetimibe (n=77), 56.27±25.8 mg/dl for statin alone (n=15), 69.9±14.9 mg/dl for ezetimibe alone (n=8), and 72.4±25.1 mg/dl for no added treatment (n=38) (p<0.0001). The control rates were 88.3%, 66.7%, 50.0%, and 42.1%, respectively (p<0.0001). Patients on a statin plus ezetimibe had double the likelihood of achieving control (RR = 2.1, 95% CI:1.4-3.1). We did not find differences in the primary outcomes between patients treated with alirocumab or evolucumab.Conclusion and Relevance Overall, more than two-thirds of the patients had their cLDL levels under control, with those adhering to a high-efficacy statin plus ezetimibe treatment regimen demonstrating significantly better outcomes compared to other treatment groups.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitari Arnau De Vilanova, Pharmacy, Lleida, Spain"
      ],
      "name": "JA Schoenenberger Arnaiz"
    },
    {
      "affiliations": [
        "Hospital Universitari Arnau De Vilanova, Pharmacy, Lleida, Spain"
      ],
      "name": "M Bardoll-Cucala"
    },
    {
      "affiliations": [
        "Hospital Universitari Santa Maria, Pharmacy, Lleida, Spain"
      ],
      "name": "M Nevot-Blanc"
    },
    {
      "affiliations": [
        "Hospital Universitari Arnau De Vilanova, Pharmacy, Lleida, Spain"
      ],
      "name": "I Couceiro-Zamora"
    },
    {
      "affiliations": [
        "Hospital Universitari Arnau De Vilanova, Cardiology, Lleida, Spain"
      ],
      "name": "F Worner-Diz"
    },
    {
      "affiliations": [
        "Hospital Universitari Arnau De Vilanova, Neurology, Lleida, Spain"
      ],
      "name": "G Mauri-Capdevila"
    },
    {
      "affiliations": [
        "Hospital Universitari Arnau De Vilanova, Endocrinology, Lleida, Spain"
      ],
      "name": "MD Santos-Rey"
    },
    {
      "affiliations": [
        "Hospital Universitari Santa Maria, Internal Medicine, Lleida, Spain"
      ],
      "name": "G Torres-Cortada"
    },
    {
      "affiliations": [
        "Universitat De Lleida, Medicine, Lleida, Spain"
      ],
      "name": "X Gomez-Arbones"
    },
    {
      "affiliations": [
        "Hospital Comarcal Del Pallars, Pharmacy, Tremp, Spain"
      ],
      "name": "F Torres-Bondia"
    }
  ],
  "title": "5PSQ-039 Impact of added lipid-lowering therapy on control of LDL cholesterol levels in patients receiving alirocumab or evolucumab: a comparative analysis in real-world clinical practice",
  "uid": "719446bc-c6c9-5200-a851-4c3465c94bea"
}