Multilevel Factors Predict Medication Adherence and Efficacy within 12 Months in Patients Receiving PCSK9 Monoclonal Antibodies: The Findings from a Real-World Analysis in China.

IF 3 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of atherosclerosis and thrombosis Pub Date : 2025-04-05 DOI:10.5551/jat.65624

Xiaomeng Zheng, Yiyi Jin, Miao Fan, Hanbin Cui, Suyan Zhu

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Abstract

Aims: To investigate the predictors associated with inadequate adherence in patients receiving proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mAbs) in China and to assess the mean LDL-C levels and the percentage reduction of LDL-C.

Methods: Patients with at least one PCSK9-mAbs prescription filled between January 2021 and December 2022 were included in this study. The LDL-C levels before and after treatment initiation were assessed using medical records. Adherence to PCSK9-mAbs was assessed for up to 12 months after treatment initiation using the proportion of days covered.

Results: A total of 415 patients were enrolled. The medication adherence to PCSK9-mAbs after 12 months was 31.8%. A multivariate analysis revealed that better education (junior or high school adjusted OR 2.7 and college or higher adjusted OR 5.2) and LDL-C ＜1.4 mmol/L at 3 months after starting PCSK9-mAbs (adjusted OR 3.0) were consistent predictors of adherence. At 12 months, LDL-C was 1.5mmol/L in the adherence group (mean [SD] decrease, 44.5% [26.5%]) and 1.9 mmol/L in the poor adherence group (mean [SD] decrease, 31.0% [32.7%]), with a group difference of 0.42 mmol/L (group difference in decrease, 13.48%).

Conclusions: A better education and LDL-C ＜1.4 mmol/L at 3 months after starting treatment with PCSK9-mAbs were consistent predictors of adherence. In addition, the treatment effect declined more significantly in the poor adherence group over time.

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多水平因素预测接受PCSK9单克隆抗体患者12个月内的药物依从性和疗效：来自中国真实世界分析的结果

目的：研究在中国接受枯草杆菌蛋白转化酶9型（PCSK9）单克隆抗体（mab）治疗的患者依从性不足的相关预测因素，并评估平均LDL-C水平和LDL-C降低的百分比。方法：在2021年1月至2022年12月期间至少使用一种pcsk9 - mab处方的患者纳入本研究。使用医疗记录评估治疗开始前后LDL-C水平。在治疗开始后的12个月内，使用覆盖天数的比例评估pcsk9 - mab的依从性。结果：共纳入415例患者。12个月后对pcsk9 - mab的药物依从性为31.8%。一项多因素分析显示，更好的教育（初中或高中调整or为2.7，大学或更高水平调整or为5.2）和开始使用pcsk9 - mab后3个月LDL-C <1.4 mmol/L（调整or为3.0）是依从性的一致预测因素。12个月时，依从组LDL-C为1.5mmol/L（平均[SD]降低44.5%[26.5%]），依从不良组LDL-C为1.9 mmol/L（平均[SD]降低31.0%[32.7%]），组间差异为0.42 mmol/L（组间差异为降低13.48%）。结论：接受更好的教育和开始使用pcsk9 - mab治疗3个月后LDL-C <1.4 mmol/L是依从性的一致预测因素。此外，随着时间的推移，依从性差组的治疗效果下降更为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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