协会的PCSK9抑制剂启动对他的坚持和停止
Christopher LaFratte1, Samuel K Peasah2,3, Yan Huang2
1Department of Pharmacy UPMC Pittsburgh PA USA.
Journal of the American Heart Association
|September 13, 2023
概括
启动蛋白转化酶子素/素9型抑制剂 (PCSK9i) 有效降低LDL胆固醇,但与降低他类药物的坚持和增加他类药物的停用有关. 这凸显了长期心血管风险管理的潜在挑战.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 健康 结果 研究 研究 结果
背景情况:
- 当与他类药物一起使用时,蛋白转化酶亚提利辛/凯类型9抑制剂 (PCSK9i) 有效降低胆固醇和减少心血管事件.
- 有关PCSK9i启动对患者对他类药物治疗的坚持的影响存在担忧.
- 了解PCSK9i和他类药物坚持之间的相互作用对于优化长期心血管结果至关重要.
研究的目的:
- 评估PCSK9抑制剂的开始与随后的他类药物坚持和停止治疗的变化之间的关联.
- 评估PCSK9i对低密度脂蛋白胆固醇水平和住院率的影响.
主要方法:
- 进行了回顾性前后差异分析.
- 新PCSK9i声称的倾向与2017年4月至2019年9月的单独他类药物使用者相匹配.
- 主要结局包括在开始后12个月内坚持使用他类药物 (覆盖日数的比例) 和停止使用他类药物 (没有覆盖的≥60天).
主要成果:
- 与单独使用他的使用者相比,PCSK9i启动与覆盖日的平均他比例显著下降 (从67%降至48%) (从68%增加至86%).
- 在PCSK9i组 (11%至39%) 中,他类药物停用率大幅增加,而仅使用他类药物组 (7%至9%) 中则有所增加.
- 在68%的患者中,PCSK9i显著改善了低密度脂蛋白胆固醇水平 (<70 mg/dL),而仅服用他类药物组中这一比例为24%.
结论:
- 开始使用PCSK9抑制剂与降低他类药物的坚持和增加他类药物的停用有关.
- 尽管降低了他类药物的坚持,但PCSK9i有效降低了LDL胆固醇.
- 需要进行进一步的研究,以解决 PCSK9 抑制剂治疗的患者降低他类药物的坚持的影响.
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