Key result
Adequate PCSK9 inhibitor adherence linked to ~13% greater LDL-C reduction at 12 months.
Why the study?
What factors predict medication adherence and efficacy in patients receiving PCSK9 monoclonal antibodies?
Cohort (n=415)
What factors predict medication adherence and efficacy in patients receiving PCSK9 monoclonal antibodies?
Real-world adherence to PCSK9 inhibitors in China is low at 12 months, with better education and early LDL-C response predicting better long-term adherence and efficacy.
AIMS: To investigate the predictors associated with inadequate adherence in patients receiving proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mAbs) in China and to assess the mean LDL-C levels and the percentage reduction of LDL-C. METHODS: Patients with at least one PCSK9-mAbs prescription filled between January 2021 and December 2022 were included in this study. The LDL-C levels before and after treatment initiation were assessed using medical records. Adherence to PCSK9-mAbs was assessed for up to 12 months after treatment initiation using the proportion of days covered. RESULTS: A total of 415 patients were enrolled. The medication adherence to PCSK9-mAbs after 12 months was 31.8%. A multivariate analysis revealed that better education (junior or high school adjusted OR 2.7 and college or higher adjusted OR 5.2) and LDL-C ＜1.4 mmol/L at 3 months after starting PCSK9-mAbs (adjusted OR 3.0) were consistent predictors of adherence. At 12 months, LDL-C was 1.5mmol/L in the adherence group (mean [SD] decrease, 44.5% [26.5%]) and 1.9 mmol/L in the poor adherence group (mean [SD] decrease, 31.0% [32.7%]), with a group difference of 0.42 mmol/L (group difference in decrease, 13.48%). CONCLUSIONS: A better education and LDL-C ＜1.4 mmol/L at 3 months after starting treatment with PCSK9-mAbs were consistent predictors of adherence. In addition, the treatment effect declined more significantly in the poor adherence group over time.
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Zheng et al. (2025) conducted a cohort in Hyperlipidemia (patients receiving PCSK9 monoclonal antibodies) (n=415). Adequate adherence to PCSK9 monoclonal antibodies vs. Poor adherence was evaluated on Percentage reduction of LDL-C at 12 months (MD 13.48%). Adequate adherence to PCSK9 monoclonal antibodies resulted in a greater mean LDL-C reduction at 12 months compared to poor adherence (44.5% vs 31.0%, difference of 13.48%).
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