4CPS-230 Time course of hypercholesterolaemia treatment with PCSK9 inhibitors monoclonal antibodies (iPCSK9)

<h3>Background and Importance</h3> Monoclonal antibodies directed against the PCSK9 protein revolutionised the treatment for hypercholesterolaemia 5 years ago. It is necessary to review the effectiveness data over time in real clinical practice. <h3>Aim and Objectives</h3> To find out the evolution over time of the effectiveness of hypercholesterolaemia treatment with iPCSK9 (alirocumab/evolocumab). <h3>Material and Methods</h3> Observational, retrospective, analytical and descriptive study in a second-level hospital including patients diagnosed with hypercholesterolaemia who started iPCSK9 treatment from September 2017 to March 2023. Inclusion criteria: age&gt;18 years, on treatment for at least 12 months with alirocumab (75mg/14 days or 150 mg/28 days) and evolocumab (140 mg/14 days). Intensification dosing was alirocumab 150 mg/14 days. Efficacy variables were collected: baseline LDL value (LDLb), LDL at 1/3/6/12 months, target LDL, dates of: start/end of treatment, change of dosage, reaching target (100/70/70/55mg/dL according to patient need), reaching 50% LDLb reduction. The data were obtained from the patient‘s clinical history and the electronic dispensing register. Statistical analysis was performed with STATA software using Kaplan-Meier curve analysis and Mantel-Haenszel test. <h3>Results</h3> Forty patients were included, 50% were treated with alirocumab 75mg/14 days, 22.5% with alirocumab 150 mg/28days and 27.5% with evolocumab 140 mg/14 days. Finally, at 14 months, at least 50% of patients needed to intensify alirocumab dosing. Comparing both starting doses of alirocumab, it was observed that the median time to intensification was 7 months with 75mg/14 days dose, while it was 33 months with the monthly dose (150 mg/month) (p=0.02). <h3>Conclusion and Relevance</h3> IPCSK9 have proven to be effective drugs in a short period of time for the treatment of hypercholesterolaemia, with 50% of patients reaching target LDL levels within 6 months. Those patients on alirocumab treatment have on average needed to intensify dosing in just over a year, however the baseline dose(150mg/month) has been proven more effective over time. Evolocumab seems to be faster in achieving the 50% of LDL reduction. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest