Insights from Patients and Physicians About Use of Evolocumab for LDL-C Management

Low-density lipoprotein-cholesterol (LDL-C) is a causal modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD), and evolocumab-a proprotein subtilisin/kexin type 9 (PCSK9) inhibitor monoclonal antibody-is effective in substantially decreasing LDL-C concentrations. However, many patients who might benefit from PCSK9 inhibitor treatment as per current guideline recommendations will not receive it. Our study aimed to assess patient and physician satisfaction with evolocumab, including perceptions of treatment experience and effectiveness.

The Treatment Satisfaction Questionnaire for Medication (TSQM)-9 (nine items; 7- or 5-point Likert scale responses) evaluated satisfaction in 130 adult patients (50% women) using evolocumab. A separate survey (five items; 5-point Likert scale responses) was developed to evaluate satisfaction in 130 physicians (50% primary care providers, 50% cardiologists) who prescribe evolocumab. Participants were recruited in the USA from pre-existing panels. Samples were stratified by US region (West, South, Northeast, and Midwest).

Overall 96.1% of patients (mean age 53 years; 78% white) and 90.8% of physicians (mean age 50 years; 81% male; 63% white) were satisfied to various degrees with evolocumab. Patient reporting described various degrees of satisfaction with the ability of evolocumab to prevent or treat their condition (93.8%), relieve their symptoms (95.3%), and with the time it takes to start working (94.8%). They also found evolocumab convenient (92.3%) and easy to use (94.7%). Physicians were satisfied to various degrees with evolocumab's ability to control elevated LDL-C (93.1%) and the outcomes observed (94.6%) in their patients. They were also satisfied with evolocumab's convenience for patients (74.6%), their willingness to take it (79.2%), and its dosing frequency (85.4%).

A large majority of patients and physicians reported high satisfaction levels about their experience with evolocumab treatment. This may help inform treatment decisions when choosing lipid-lowering therapy in patients with ASCVD and elevated LDL-C concentrations.