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依洛尤单抗在真实世界环境中的疗效:来自泛欧观察性 HEYMANS 研究的奥地利数据。

Evolocumab effectiveness in the real-world setting: Austrian data from the pan-European observational HEYMANS study.

机构信息

Department of Internal Medicine I, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.

Vorarlberg Institute for Vascular Investigation & Treatment (VIVIT) at Feldkirch Academic Teaching Hospital, Feldkirch, Austria.

出版信息

Wien Klin Wochenschr. 2024 Feb;136(3-4):77-86. doi: 10.1007/s00508-023-02245-w. Epub 2023 Jul 31.

Abstract

BACKGROUND

This real-world study examined clinical characteristics and dyslipidemia management among patients initiating evolocumab across 12 European countries. Austrian data are reported.

METHODS

Data of consenting adults were collected for ≤ 6 months prior to evolocumab initiation (baseline) and ≤ 30 months post-initiation. Patient characteristics, lipid lowering therapy (LLT, i.e. statin and/or ezetimibe) and lipid values were collected from medical records.

RESULTS

In Austria, 363 patients were enrolled. At baseline, 52% of patients initiated evolocumab without background LLT; the median (Q1, Q3) initial low-density lipoprotein cholesterol (LDL-C) level was 142 (111, 187) mg/dL. Within 3 months of evolocumab treatment, median LDL‑C decreased by 59% to 58 (37, 91) mg/dL. This reduction was maintained over time, despite consistently infrequent use of background LLT. LDL-C < 55 mg/dL was attained by 65% of patients (76% with, 55% without background LLT). Evolocumab persistence was ≥ 90% at month 12 and month 30.

CONCLUSION

In Austria, patients were initiated on evolocumab at LDL‑C levels almost 3‑times higher than the guideline-recommended clinical goal (< 55 mg/dL). Persistence with evolocumab was very high. Evolocumab led to a rapid and sustained LDL‑C reduction with 65% attaining the LDL‑C goal. Patients using evolocumab in combination with statins and/or ezetimibe were more likely to attain their LDL‑C goal and thus decrease cardiovascular risk.

摘要

背景

这项真实世界研究调查了在 12 个欧洲国家开始使用依洛尤单抗的患者的临床特征和血脂异常管理情况。本报告提供了奥地利的数据。

方法

在开始依洛尤单抗治疗前(基线)和治疗后≤30 个月内,从病历中收集同意参与的成年患者的相关数据,包括≤6 个月的数据。收集患者特征、降脂治疗(即他汀类药物和/或依折麦布)和血脂值。

结果

在奥地利,共纳入 363 名患者。基线时,52%的患者在无背景降脂治疗的情况下开始使用依洛尤单抗;初始低密度脂蛋白胆固醇(LDL-C)水平的中位数(Q1,Q3)为 142(111,187)mg/dL。依洛尤单抗治疗 3 个月内,LDL-C 中位数降低了 59%,至 58(37,91)mg/dL。尽管背景降脂治疗的应用始终不频繁,但这种降低在治疗期间得以维持。65%的患者(有背景降脂治疗者为 76%,无背景降脂治疗者为 55%)达到 LDL-C<55mg/dL的目标。依洛尤单抗的持续使用率在第 12 个月和第 30 个月时均≥90%。

结论

在奥地利,患者开始使用依洛尤单抗的 LDL-C 水平几乎是指南推荐的临床目标(<55mg/dL)的 3 倍。依洛尤单抗的持续使用率非常高。依洛尤单抗可迅速且持续降低 LDL-C,65%的患者达到 LDL-C 目标。联合使用依洛尤单抗和他汀类药物和/或依折麦布的患者更有可能达到其 LDL-C 目标,从而降低心血管风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7005/10837260/b0124476499e/508_2023_2245_Fig1_HTML.jpg

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