Comparative effectiveness of different methods of prescribing rosuvastatin and ezetimibe in combination with PCSK9 inhibitors

Objective : comparative evaluation of the effectiveness of combined lipid-lowering therapy with rosuvastatin and ezetimibe in fixed and separate combinations with PCSK9 inhibitors in patients with very high cardiovascular risk. Materials and methods : 65 study participants were divided into 2 groups depending on the method of combined lipid-lowering therapy and were observed for 5 months on 6 visits. The effectiveness of the hypolipidemic response in each of the studied groups was evaluated. Results: in the group with separate administration of lipid-lowering drugs, the target values of LDL cholesterol reached 50% of patients, the level of LDL cholesterol during 5 months of treatment decreased by 38.22% from 2.25 [1.82; 2.47] mmol/l to 1.39 [1.21; 1.59] mmol/l (p <0.001). In the group with a fixed combination of rosuvastatin and ezetimibe, 61.29% of the study participants reached the target ranges of LDL cholesterol, the concentration of LDL cholesterol decreased by 47.46% from 2.36 [1.92; 2.57] mmol/l to 1.24 [1.18; 1.56] mmol/l (p <0.001). Logistic regression analysis showed a significant association of females with a higher risk of not reaching the target ranges of LDL cholesterol (χ 2 <0.001; OR 0.13 95 % CI 0.04-0.39; p<0.001). Conclusion : the use of a fixed combination of rosuvastatin and ezetimibe in combination with PCSK9 inhibitors in patients with very high cardiovascular risk makes it possible to reduce the concentration of LDL cholesterol by 9.24% more intensively relative to the drug regimen with separate administration of drugs.