A UK multicentre audit of the management of patients with primary hypercholesterolaemia or mixed dyslipidaemia with bempedoic acid against published lipid-lowering treatment targets
Ramachandran, Sudarshan Maarouf, Amro Mitchell, Karen Avades, Tony Smith, Peter Boulton, Lee Kelly, Jennifer Vekaria, Nitasha Hughes, Elizabeth
Ramachandran, Sudarshan
Maarouf, Amro
Mitchell, Karen
Avades, Tony
Smith, Peter
Boulton, Lee
Kelly, Jennifer
Vekaria, Nitasha
Hughes, Elizabeth
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Affiliation
University Hospitals Birmingham NHS Foundation Trust; Calderdale and Huddersfield NHS Foundation Trust; University Hospitals Plymouth NHS Trust; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2024-08-08
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Abstract
Background: Bempedoic acid, an adenosine triphosphate citrate lyase inhibitor, was introduced to UK practice via a pre-reimbursement access scheme for adults with primary hypercholesterolaemia or mixed dyslipidaemia who are at high risk of cardiovascular disease, in whom statins are either not tolerated or contraindicated, who have not achieved target cholesterol, despite being on ezetimibe therapy, and do not qualify for PCSK9 inhibitor treatment. This retrospective multicentre audit aimed to evaluate the achievement of lipid-lowering targets with bempedoic acid in UK patients based on recommendations in the Joint British Societies (JBS) guidelines for the prevention of cardiovascular disease. Methods: Pseudo-anonymized medical record data for 221 adults treated with bempedoic acid as part of the UK scheme were entered into a bespoke data collection tool at four UK hospitals. Patient demographics, clinical characteristics, treatment pathways and lipid assessment results (against JBS lipid-lowering targets) were collected against pre-specified criteria. Results: Overall, 54% (99/184) of patients achieved the JBS2 audit standard (total cholesterol (TC) <5 mmol/L and low-density lipoprotein cholesterol (LDL-C) <3 mmol/L or ≥25% reduction in TC and ≥30% reduction in LDL-C) at 12 weeks post-initiation. At week 12, the mean absolute change in LDL-C was -1.0 mmol/L; the mean percentage reduction from baseline was 22.0%. Additionally, 52% (96/185) of patients had an LDL-C of <3 mmol/L and 10% (18/185) an LDL-C of <1.8 mmol/L at 12 weeks (as per JBS3). Conclusion: This audit highlights the role of bempedoic acid as part of combination therapy for a population with previously limited treatment options.
Citation
Ramachandran S, Maarouf A, Mitchell K, Avades T, Smith P, Boulton L, Kelly J, Vekaria N, Hughes E. A UK multicentre audit of the management of patients with primary hypercholesterolaemia or mixed dyslipidaemia with bempedoic acid against published lipid-lowering treatment targets. Drugs Context. 2024 Aug 8;13:2024-2-4. doi: 10.7573/dic.2024-2-4.
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Article