TY - JOUR
T1 - Anti PCSK9 Monoclonal Antibody Treatment in Elderly Patients
T2 - A Real-world Clinical Experience
AU - Giladi, Eia
AU - Israel, Roy
AU - Daud, Wasseem
AU - Gurevitz, Chen
AU - Atamna, Alaa
AU - Pereg, David
AU - Assali, Abid
AU - Elis, Avishay
N1 - Publisher Copyright:
© 2024 Israel Medical Association. All rights reserved.
PY - 2024/2
Y1 - 2024/2
N2 - Background: The use of proprotein convertase subtili-sin/kexin type 9 monoclonal antibodies (PCSK9 mAbs) is emerging for lowering low-density lipoprotein cholesterol (LDL-C). However, real-world data is lacking for their use among elderly patients. Objective: To define the characteristics of elderly patients treated with PCSK9 mAbs and to evaluate the efficacy and tolerability compared with younger patients. Methods: We conducted a retrospective cohort study of elderly patients (≥ 75 years at enrollment) treated with PCSK9 mAbs for primary and secondary cardiovascular prevention. Data were retrieved for demographic and clinical characteristics; indications for treatment; agents and dosages; concomitant lipid lowering treatment; LDL-C levels at baseline, 6,12 months, and at the end of follow up. Data also included achieving LDL-C target levels and adverse effects. Results: The cohort included 91 elderly patients and 92 younger patients, mean age 75.2 ± 3.76 and 58.9 ± 7.4 years [P < 0.0001). Most patients (82%, 80%) were in high/very high-risk categories. For almost all (98%, 99%), the indication was statin intolerance, with PCSK9 mAb monotherapy the most prevalent regimen. The average follow-up was 38.1 ± 20.5 and 30.9 ± 15.8 months (P= 0.0258). Within 6 months the LDL-C levels were reduced by 57% in the elderly group and by 59% in the control group (P = 0.2371). Only 53% and 57% reached their LDL-C target levels. No clinically significant side effects were documented. Conclusion: PCSK9 mAbs have similar effects and are well tolerated among elderly patients as in younger patients.
AB - Background: The use of proprotein convertase subtili-sin/kexin type 9 monoclonal antibodies (PCSK9 mAbs) is emerging for lowering low-density lipoprotein cholesterol (LDL-C). However, real-world data is lacking for their use among elderly patients. Objective: To define the characteristics of elderly patients treated with PCSK9 mAbs and to evaluate the efficacy and tolerability compared with younger patients. Methods: We conducted a retrospective cohort study of elderly patients (≥ 75 years at enrollment) treated with PCSK9 mAbs for primary and secondary cardiovascular prevention. Data were retrieved for demographic and clinical characteristics; indications for treatment; agents and dosages; concomitant lipid lowering treatment; LDL-C levels at baseline, 6,12 months, and at the end of follow up. Data also included achieving LDL-C target levels and adverse effects. Results: The cohort included 91 elderly patients and 92 younger patients, mean age 75.2 ± 3.76 and 58.9 ± 7.4 years [P < 0.0001). Most patients (82%, 80%) were in high/very high-risk categories. For almost all (98%, 99%), the indication was statin intolerance, with PCSK9 mAb monotherapy the most prevalent regimen. The average follow-up was 38.1 ± 20.5 and 30.9 ± 15.8 months (P= 0.0258). Within 6 months the LDL-C levels were reduced by 57% in the elderly group and by 59% in the control group (P = 0.2371). Only 53% and 57% reached their LDL-C target levels. No clinically significant side effects were documented. Conclusion: PCSK9 mAbs have similar effects and are well tolerated among elderly patients as in younger patients.
KW - elderly
KW - low-density lipoprotein cholesterol (LDL-C)
KW - pro-protein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9 mAbs)
KW - statins
UR - http://www.scopus.com/inward/record.url?scp=85186742856&partnerID=8YFLogxK
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C2 - 38420988
AN - SCOPUS:85186742856
SN - 1565-1088
VL - 26
SP - 130
EP - 135
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 2
ER -