PCSK9 Inhibitors (A Novel Cholesterol Lowering Medicine) Use in the Management of Cardiovascular Disease (CVD), Isle of Wight Experience, UK

Elevated LDL cholesterol remains an important driver for CVD and a primary cause of premature cardiovascular mortality and morbidity. Many randomised, controlled trials have proven the utility of statins in reducing LDL cholesterol and cardiovascular disease during the last 25 years. An exciting new treatment for marked reduction of LDL cholesterol levels is now on the horizon: the PCSK9 inhibitors, a new novel class of biologics given subcutaneously once every two weeks. The aim of this survey was to review the use of PCSK9 inhibitor, to assess the magnitude of LDL reduction, safety profile among CVD patients with statin intolerance/familial hypercholesterolaemia (FH) not achieving optimal cholesterol target for primary/secondary prevention of CVD.

This was a retrospective local clinical survey in which all patients prescribed PCSK9 inhibitors in the lipid clinic between the periods (April 2016 – April 2017) had their case notes/Clinic letters and lipid indices were reviewed.

Results: 22 patients were prescribed PCSK9 inhibitor (Evolocumab and Alirocumab). 11 (50%) out of the 22 were patients with familial hypercholesterolaemia (5/11 confirmed genetically). 8 (36%) out of the 22 had an established CVD (MI/CABG/PVD/Stroke). 13 out of the 16 patients had a follow up visits and achieved an LDL cholesterol target
Conclusion: PCSK9 inhibitors was well tolerated by the majority of our cohort, none of the patients had suffered serious adverse effect. A large proportion of the patients achieved the LDL target recommended for the secondary prevention of CVD.