Department of Cardiology, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Pharmacy, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
J Formos Med Assoc. 2022 Sep;121(9):1877-1880. doi: 10.1016/j.jfma.2021.11.007. Epub 2021 Nov 29.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, alirocumab and evolocumab, are currently approved for clinical use by Taiwan National Health Insurance (NHI) in patients who had a recent atherosclerotic cardiovascular disease with persistent LDL-C levels >135 mg/dL despite high-intensity statin (HIS) or maximally tolerated statin in combination with ezetimibe treatment. Since January 2020 to July 2020, total of 10 patients who had received coronary revascularization received NHI-approved alirocumab or evolocumab in our institution. The mean reduction of LDL-C following PCSK9 inhibitors treatment at 6-month and 12-month were respectively 62.5% and 60.2%. The patients in our study were younger, had more frequently received HIS/ezetimibe, and had higher baseline LDL-C levels with a greater LDL-C reduction following PCSK9 inhibitors treatment compared with those patients in previously studies. Our findings highlight that the NHI's regulation of PCSK9 inhibitors application should be re-evaluation to increase the use of NHI-approved PCSK9 inhibitors in high-risk patients.
前蛋白转化酶枯草溶菌素 9（PCSK9）抑制剂，阿利西尤单抗和依洛尤单抗，目前被台湾全民健康保险（NHI）批准用于近期发生动脉粥样硬化性心血管疾病且 LDL-C 水平持续 >135mg/dL 的患者，尽管使用高强度他汀类药物（HIS）或最大耐受他汀类药物联合依折麦布治疗。自 2020 年 1 月至 2020 年 7 月，共有 10 名在我院接受过冠状动脉血运重建术的患者接受了 NHI 批准的阿利西尤单抗或依洛尤单抗治疗。应用 PCSK9 抑制剂治疗 6 个月和 12 个月后 LDL-C 的平均降幅分别为 62.5%和 60.2%。与先前研究中的患者相比，我们研究中的患者更年轻，更频繁地接受 HIS/依折麦布治疗，基线 LDL-C 水平更高，应用 PCSK9 抑制剂治疗后 LDL-C 降幅更大。我们的研究结果表明，NHI 对 PCSK9 抑制剂应用的监管应重新评估，以增加高危患者对 NHI 批准的 PCSK9 抑制剂的使用。
