146 - German lipid clinic experience with adherence to PCSK-9-inhibitor therapy (ID 672)
Abstract
Background and Aims
PCSK-9-inhibitors (PCSK-9-i) are a highly effective treatment option to lower LDL-cholesterol and reduce cardiovascular events. Published US-data show that a large portion of patients does not continue medication after one prescription. This is associated with higher rates of cardiovascular events. We aimed to assess access and adherence to PCSK-9-i in a German patient cohort.
Methods
We identified 238 individuals (49.6% male, age 64±11yrs, BMI 23.5±4kg/m², 22.3% on high intensity statin therapy, 21% partial/ 56.7% total statin intolerant) who presented to our lipid clinic with the indication for treatment with PCSK-9-i and an initial prescription at our clinic between 2015 and 2018. We evaluated continuation of treatment rates after one year.
Results
After one year 80.3% continued treatment with regular presentations and prescriptions from our institution. 47 patients (19.7%) did not return. Of those 8 patients (3.4%) were lost to follow up, 15 (6.3%) received PCSK9-i from other physicians, 17 (7.1%) stopped medication because of side effects, 7 (2.9%) stopped for other reasons (patient wish n=4, lack of efficacy in homozygous FH, planned pregnancy, lack of access).
Conclusions
In contrast to published US data our experience indicates good adherence and a high retention rate. This may be due to well selected patients (clear indication), regular follow-up in a specialized center and only minimal or no co-payment in Germany.
