LIPID–LOWERING THERAPY WITH PCSK9 INHIBITORS: FAMILIAL HYPERCHOLESTEROLEMIA VS GENERAL POPULATION OUTCOMES

Dyslipidemic patients, particularly those with familial hypercholesterolemia (FH), are at increased risk of cardiovascular events and require beginning a full treatment. This study aims to compare the long–term effects of PCSK9i treatment in FH and non–FH dyslipidemic patients.

The study enrolled 381 dyslipidemic patients receiving PCSK9 inhibitors in our dyslipidemia outpatient clinic. FH was defined in accordance with the Dutch Lipid Clinic Network Criteria. The clinical data were collected in both groups and lipid profiles were monitored at 6, 12, and 36 months.

In patients with FH baseline total cholesterol was significantly higher(260±54.8 mg/dL vs 212±51.3 mg/dL p < 0.001) as well as LDL cholesterol (181.4±51.7 mg/dL vs 137±45.1 mg/dL p < 0.001). A lipid reduction was observed in both groups at 6 months (LDL 69±41 mg/dL vs 62±37 mg/dL p = 0.20) at 12 (LDL 66±41 mg/dL vs 66±40 mg/dL p = 0.96) and 36 months (LDL 73±45 mg/dL vs 72±35 mg/dL p = 0.92).

PCSK9i treatment is highly effective in reducing LDL–C levels in both FH and non–FH dyslipidemic patients. The Achievement of similar LDL–C levels between these two groups in long–term follow–up could suggest that PCSK9i therapy is equally efficacious in both populations despite different dyslipidemia settings.