Clinical profile of patients treated with evolocumab in lipid/internal medicine units of Spain. Observational study (RETOSS-IMU).

Autor:	Masana L; Servicio de Medicina Interna, Hospital Universitario Sant Joan, IISPV, CIBERDEM, Reus, Tarragona, España. Electronic address: luis.masana@urv.cat., López Miranda J; Servicio de Medicina Interna, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBEROBN, Córdoba, España., Civeira F; Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España., Reinares L; Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España., Guijarro C; Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España., Plana N; Servicio de Medicina Interna, Hospital Universitario Sant Joan, IISPV, CIBERDEM, Reus, Tarragona, España., Cuenca R; Servicio de Medicina Interna, Hospital Alto Guadalquivir, Andújar, Jaén, España., Sánchez D; Servicio de Medicina Interna, Hospital Nuestra Señora de Sonsoles, Ávila, España., Hernández JL; Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, España., Andrés R; Servicio de Medicina Interna, Hospital Universitario Fundación Jiménez Díaz, Madrid, España., Blanco A; Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España., Villamayor S; Departamento Médico, Amgen S.A., Barcelona, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis [Clin Investig Arterioscler] 2020 Sep - Oct; Vol. 32 (5), pp. 183-192. Date of Electronic Publication: 2020 Apr 18.
DOI:	10.1016/j.arteri.2020.02.003
Abstrakt:	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 12weeks pre-initiation and 12±4weeks 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 160mg/dL in 46.4% of patients, and ≥190mg/dL in 26.5%. During the observation period, evolocumab produced significant reductions in LDL-C of 55.7% (P<.0001), achieving mean values of 74.3mg/dL. At week12, more than half (53.8%) of patients achieved LDL-C levels <70mg/dL, and 26.9% <50mg/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. (Copyright © 2020 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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