Author, as appears in the article.: Masana Marín, Lluís; López Miranda, José; Civeira Murillo, Fernando; Reinares García, Leonardo; Guijarro, Carlos; Plana Gil, Núria; Cuenca, Rafael; Sánchez Fuentes, Demetrio; Hernández, José Luis; Andrés Cañas, Raimundo; Blanco Echevarría, Agustín; Villamayor, Santiago

Department: Medicina i Cirurgia

URV's Author/s: Masana Marín, Luis / Plana Gil, Núria

Keywords: Lipid unit/internal medicine Ldl-c Familial hypercholesterolaemia Evolocumab Cldl Arteriosclerotic cardiovascular disease unidades de lípidos/medicina interna lipid unit/internal medicine ldl-c hipercolesterolemia familiar familial hypercholesterolaemia evolocumab enfermedad cardiovascular arteriosclerótica arteriosclerotic cardiovascular disease

Abstract: © 2020 The Authors Objective: To describe the clinical characteristics, the reasons for initiating therapy, and the effects of treatment in the initial phase of evolocumab availability in lipid/internal medicine units in Spain. Methods: Retrospective, observational study, based on the medical records of consecutive patients initiating treatment with evolocumab (from February 2016 to July 2017) in 20 internal medicine units in Spain. A review was made of the demographic and clinical characteristics of the patients, the lipid lowering treatment, and the evolution of the lipid profiles between 12 weeks pre-initiation and 12 ± 4 weeks post-initiation of evolocumab. Results: A total of 136 patients were analysed, of whom 64.0% were men, and the mean age (standard deviation, SD) was 56.6 (11.5) years. The large majority (75%) had familial hypercholesterolaemia (4 homozygous), and 51.0% of them had suffered at least one cardiovascular event. Atherosclerotic cardiovascular disease (ASCVD) was present in 61% of all patients. At initiation of evolocumab, 61.0% of the patients were taking high-intensity statins, and 60.3% were receiving ezetimibe. The mean (and SD) of LDL-C levels at initiation of evolocumab was 169.1 (56.6) mg/dL. The LDL-C was greater than 160 mg/dL in 46.4% of patients, and ≥ 190 mg/dL in 26.5%. During the observation period, evolocumab produced significant reductions in LDL-C of 55.7% (P < .0001), achieving mean values of 74.3 mg/dL. At week 12, more than half (53.8%) of patients achieved LDL-C levels < 70 mg/dL, and 26.9% < 50 mg/dL. Conclusions: In the lipid/internal medicine units, evolocumab was mainly prescribed in patients with familial hypercholesterolaemia, with or without ASCVD. The initial use of evolocumab was in accordance with the guidelines of the Spanish Society of Arteriosclerosis (SEA) of 2016, with LDL-C levels being well above the recommended thresholds for treatment initiation. Evolocumab treatment in clinical practice reduced LDL-C levels by about 55%, a similar reduction to that reported in clinical trials. Most patients achieved LDL-C goals.

Thematic Areas: Pharmacology (medical) Peripheral vascular disease Medicina iii Medicina i Cardiology and cardiovascular medicine

licence for use: https://creativecommons.org/licenses/by/3.0/es/

ISSN: 15781879

Author's mail: nuria.plana@urv.cat luis.masana@urv.cat

Author identifier: 0000-0002-4231-7618 0000-0002-0789-4954

Record's date: 2023-02-19

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://www.sciencedirect.com/science/article/pii/S0214916820300243?via%3Dihub

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Clinica E Investigacion En Arteriosclerosis. 32 (5): 183-192

APA: Masana Marín, Lluís; López Miranda, José; Civeira Murillo, Fernando; Reinares García, Leonardo; Guijarro, Carlos; Plana Gil, Núria; Cuenca, Rafael; Sá (2020). Clinical profile of patients treated with evolocumab in lipid/internal medicine units of Spain. Observational study (RETOSS-IMU). Clinica E Investigacion En Arteriosclerosis, 32(5), 183-192. DOI: 10.1016/j.arteri.2020.02.003

Article's DOI: 10.1016/j.arteri.2020.02.003

Entity: Universitat Rovira i Virgili

Journal publication year: 2020

Publication Type: Journal Publications