Demographic And Clinical Characteristics Of Patients Prescribed Proprotein Convertase Subtilisin/kexin Type 9 Inhibitor Therapy And Patients Whose Current Lipid-Lowering Therapy Was Modified

Figures & data

Figure 1 Study design and patient population: study period from 7/1/2013 to 12/31/2017.

Notes: ^aFloating 2-year index period that changed with the exact index date for each patient. For example, if a patient was indexed on 7/1/2016, the 2-year pre-index period would be from 7/1/2014 to 7/1/2016. Only patients indexed exactly on the first day of the indexing period (7/1/2015) would have a pre-index period from 7/1/2013 to 7/1/2015.
Abbreviations: ACC, American College of Cardiology; ASCVD, atherosclerotic CV disease; CV, cardiovascular; FIA, Formulary Impact Analyzer; IS, ischemic stroke; LDL-C, low-density lipoprotein cholesterol; LLT, lipid-lowering therapy; MACE, major adverse CV events; MI, myocardial infarction; P+, PharMetrics Plus; PCSK9, proprotein convertase subtilisin/kexin type 9; UA, unstable angina.

Table 1 Baseline Demographic And Clinical Characteristics: Matched Cohorts

	PCSK9 Inhibitor Requested (N=12,345)	LLT Regimen Intensified/Switched/Augmented (N=12,345)
Demographics
Age, years
Mean (SD)	66.2 (9.8)	64.1 (11.0)
Median	67	64
Age group, n (%)
18–34 years	30 (0.2)	83 (0.7)
35–44 years	206 (1.7)	419 (3.4)
45–54 years	1,242 (10.1)	1,822 (14.8)
55–64 years	3,654 (29.6)	3,971 (32.2)
≥65 years	7,213 (58.4)	6,050 (49.0)
Sex, n (%)
Men	5,712 (46.3)	5,834 (47.3)
Women	6,633 (53.7)	6,511 (52.7)
Geographic region, n (%)
Northeast	2,469 (20.0)	2,920 (23.7)
Midwest	937 (7.6)	1,109 (9.0)
South	7,245 (58.7)	6,763 (54.8)
West	1,694 (13.7)	1,553 (12.6)
Payer type, n (%)
Commercial	7,348 (59.5)	6,969 (56.5)
Medicare	4,935 (40.0)	4,774 (38.7)
Other	62 (0.5)	602 (4.9)
Clinical characteristics
CCI
Mean (SD)	2.5 (2.5)	2.6 (2.8)
Median	2	2
≥3 comorbidities, n (%)	4,894 (39.6)	4,868 (39.4)
LLT use, n (%)
Statin only	5,525 (44.8)	11,734 (95.0)
High intensity	1,738 (14.1)	1,856 (15.0)
Medium intensity	2,962 (24.0)	7,717 (62.5)
Low intensity	825 (6.7)	2,161 (17.5)
Statin + ezetimibe	2,444 (19.8)	611 (5.0)
High intensity	955 (7.7)	128 (1.0)
Medium intensity	1,110 (9.0)	403 (3.3)
Low intensity	379 (3.1)	80 (0.7)

Abbreviations: CCI, Charlson Comorbidity Index; LLT, lipid-lowering therapy; PCSK9, proprotein convertase subtilisin/kexin type 9.

Figure 2 Mean baseline LDL-C value at index.

Note: To convert from mg/dL to mmol/L, multiply by 0.02586.
Abbreviations: LDL-C, low-density lipoprotein cholesterol; LLT, lipid-lowering therapy; PCSK9, proprotein convertase subtilisin/kexin type 9.

Figure 3 ASCVD diagnoses (A) and cardiovascular comorbidities and risk factors (B).

Note: ASCVD diagnoses, cardiovascular comorbidities, and risk factors were measured during the 2-year pre-index period using claims from PharMetrics Plus or IQVIA medical claims database (Dx). UA was identified through in-patient claims only; other ASCVD diagnoses were identified by at least one confirmatory (ie, nonancillary) medical claim with ICD-9/ICD-10 diagnosis codes for ASCVD conditions. “Any ASCVD” included ICD-9/ICD-10 codes for other atherosclerotic conditions such as other types of coronary atherosclerosis or other forms of chronic ischemic heart disease.
Abbreviations: ASCVD, atherosclerotic cardiovascular disease; ACS, acute coronary syndrome; CABG, coronary artery bypass graft; CKD, chronic kidney disease; FH, familial hypercholesterolemia; ICD, International Classification of Diseases; IS, ischemic stroke; MI, myocardial infarction; LDL-C, low-density lipoprotein cholesterol; LLT, lipid-lowering therapy; PCI, percutaneous coronary intervention; PCSK9, proprotein convertase subtilisin/kexin type 9; TIA, transient ischemic attack; UA, unstable angina.

Figure 4 Cardiovascular risk: ≥1 MACE during the 2-year baseline period.

Note: MACE were measured during the 2-year pre-index period using P+ or Dx claims (primary diagnoses from inpatient claims and any nonancillary diagnoses from the emergency department or outpatient claims).
Abbreviations: IS, ischemic stroke; LLT, lipid-lowering therapy; MACE, major adverse cardiovascular events; MI, myocardial infarction; P+, PharMetrics Plus; PCSK9, proprotein convertase subtilisin/kexin type 9; UA, unstable angina.