PCSK9 Inhibitor Use in the Real World: Data From the National Patient-Centered Research Network

Alanna Chamberlain, Yan Gong, Kathryn Mc Auliffe Shaw, Jiang Bian, Wen Liang Song, MacRae F. Linton, Vivian Fonseca, Eboni Price-Haywood, Emily Guhl, Jordan B. King, Rashmee U. Shah, Jon Puro, Elizabeth Shenkman, Pamala A. Pawloski, Karen L. Margolis, Adrian F. Hernandez, Rhonda M. Cooper-DeHoff

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors effectively lower LDL (low-density lipoprotein) cholesterol and have been shown to reduce cardiovascular outcomes in high-risk patients. We used real-world electronic health record data to characterize use of PCSK9 inhibitors, in addition to standard therapies, according to cardiovascular risk status. Methods and Results Data were obtained from 18 health systems with data marts within the National Patient-Centered Clinical Research Network (PCORnet) using a common data model. Participating sites identified >17.5 million adults, of whom 3.6 million met study criteria. Patients were categorized into 3 groups: (1) dyslipidemia, (2) untreated LDL ≥130 mg/dL, and (3) coronary artery disease or coronary heart disease. Demographics, comorbidities, estimated 10-year atherosclerotic cardiovascular disease risk, and lipid-lowering pharmacotherapies were summarized for each group. Participants' average age was 62 years, 50% were female, and 11% were black. LDL cholesterol ranged from 85 to 151 mg/dL. Among patients in groups 1 and 3, 54% received standard lipid-lowering therapies and a PCSK9 inhibitor was prescribed in <1%. PCSK9 inhibitor prescribing was greatest for patients with coronary artery disease or coronary heart disease and, although prescribing increased during the study period, overall PCSK9 inhibitor prescribing was low. Conclusions We successfully used electronic health record data from 18 PCORnet data marts to identify >3.6 million patients meeting criteria for 3 patient groups. Approximately half of patients had been prescribed lipid-lowering medication, but <1% were prescribed PCSK9 inhibitors. PCSK9 inhibitor prescribing increased over time for patients with coronary artery disease or coronary heart disease but not for those with dyslipidemia.

Original languageEnglish (US)
Pages (from-to)e011246
JournalJournal of the American Heart Association
Volume8
Issue number9
DOIs
StatePublished - May 7 2019

Fingerprint

Research
Dyslipidemias
Lipids
LDL Cholesterol
Coronary Disease
Coronary Artery Disease
Proprotein Convertase 9
Electronic Health Records
LDL Lipoproteins
Information Systems
Comorbidity
Cardiovascular Diseases
Demography
Drug Therapy
Health
Therapeutics

Keywords

  • coronary artery disease
  • lipids
  • PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor
  • secondary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

PCSK9 Inhibitor Use in the Real World : Data From the National Patient-Centered Research Network. / Chamberlain, Alanna; Gong, Yan; Shaw, Kathryn Mc Auliffe; Bian, Jiang; Song, Wen Liang; Linton, MacRae F.; Fonseca, Vivian; Price-Haywood, Eboni; Guhl, Emily; King, Jordan B.; Shah, Rashmee U.; Puro, Jon; Shenkman, Elizabeth; Pawloski, Pamala A.; Margolis, Karen L.; Hernandez, Adrian F.; Cooper-DeHoff, Rhonda M.

In: Journal of the American Heart Association, Vol. 8, No. 9, 07.05.2019, p. e011246.

Research output: Contribution to journalArticle

Chamberlain, A, Gong, Y, Shaw, KMA, Bian, J, Song, WL, Linton, MF, Fonseca, V, Price-Haywood, E, Guhl, E, King, JB, Shah, RU, Puro, J, Shenkman, E, Pawloski, PA, Margolis, KL, Hernandez, AF & Cooper-DeHoff, RM 2019, 'PCSK9 Inhibitor Use in the Real World: Data From the National Patient-Centered Research Network', Journal of the American Heart Association, vol. 8, no. 9, pp. e011246. https://doi.org/10.1161/JAHA.118.011246
Chamberlain, Alanna ; Gong, Yan ; Shaw, Kathryn Mc Auliffe ; Bian, Jiang ; Song, Wen Liang ; Linton, MacRae F. ; Fonseca, Vivian ; Price-Haywood, Eboni ; Guhl, Emily ; King, Jordan B. ; Shah, Rashmee U. ; Puro, Jon ; Shenkman, Elizabeth ; Pawloski, Pamala A. ; Margolis, Karen L. ; Hernandez, Adrian F. ; Cooper-DeHoff, Rhonda M. / PCSK9 Inhibitor Use in the Real World : Data From the National Patient-Centered Research Network. In: Journal of the American Heart Association. 2019 ; Vol. 8, No. 9. pp. e011246.
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abstract = "Background PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors effectively lower LDL (low-density lipoprotein) cholesterol and have been shown to reduce cardiovascular outcomes in high-risk patients. We used real-world electronic health record data to characterize use of PCSK9 inhibitors, in addition to standard therapies, according to cardiovascular risk status. Methods and Results Data were obtained from 18 health systems with data marts within the National Patient-Centered Clinical Research Network (PCORnet) using a common data model. Participating sites identified >17.5 million adults, of whom 3.6 million met study criteria. Patients were categorized into 3 groups: (1) dyslipidemia, (2) untreated LDL ≥130 mg/dL, and (3) coronary artery disease or coronary heart disease. Demographics, comorbidities, estimated 10-year atherosclerotic cardiovascular disease risk, and lipid-lowering pharmacotherapies were summarized for each group. Participants' average age was 62 years, 50{\%} were female, and 11{\%} were black. LDL cholesterol ranged from 85 to 151 mg/dL. Among patients in groups 1 and 3, 54{\%} received standard lipid-lowering therapies and a PCSK9 inhibitor was prescribed in <1{\%}. PCSK9 inhibitor prescribing was greatest for patients with coronary artery disease or coronary heart disease and, although prescribing increased during the study period, overall PCSK9 inhibitor prescribing was low. Conclusions We successfully used electronic health record data from 18 PCORnet data marts to identify >3.6 million patients meeting criteria for 3 patient groups. Approximately half of patients had been prescribed lipid-lowering medication, but <1{\%} were prescribed PCSK9 inhibitors. PCSK9 inhibitor prescribing increased over time for patients with coronary artery disease or coronary heart disease but not for those with dyslipidemia.",
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T1 - PCSK9 Inhibitor Use in the Real World

T2 - Data From the National Patient-Centered Research Network

AU - Chamberlain, Alanna

AU - Gong, Yan

AU - Shaw, Kathryn Mc Auliffe

AU - Bian, Jiang

AU - Song, Wen Liang

AU - Linton, MacRae F.

AU - Fonseca, Vivian

AU - Price-Haywood, Eboni

AU - Guhl, Emily

AU - King, Jordan B.

AU - Shah, Rashmee U.

AU - Puro, Jon

AU - Shenkman, Elizabeth

AU - Pawloski, Pamala A.

AU - Margolis, Karen L.

AU - Hernandez, Adrian F.

AU - Cooper-DeHoff, Rhonda M.

PY - 2019/5/7

Y1 - 2019/5/7

N2 - Background PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors effectively lower LDL (low-density lipoprotein) cholesterol and have been shown to reduce cardiovascular outcomes in high-risk patients. We used real-world electronic health record data to characterize use of PCSK9 inhibitors, in addition to standard therapies, according to cardiovascular risk status. Methods and Results Data were obtained from 18 health systems with data marts within the National Patient-Centered Clinical Research Network (PCORnet) using a common data model. Participating sites identified >17.5 million adults, of whom 3.6 million met study criteria. Patients were categorized into 3 groups: (1) dyslipidemia, (2) untreated LDL ≥130 mg/dL, and (3) coronary artery disease or coronary heart disease. Demographics, comorbidities, estimated 10-year atherosclerotic cardiovascular disease risk, and lipid-lowering pharmacotherapies were summarized for each group. Participants' average age was 62 years, 50% were female, and 11% were black. LDL cholesterol ranged from 85 to 151 mg/dL. Among patients in groups 1 and 3, 54% received standard lipid-lowering therapies and a PCSK9 inhibitor was prescribed in <1%. PCSK9 inhibitor prescribing was greatest for patients with coronary artery disease or coronary heart disease and, although prescribing increased during the study period, overall PCSK9 inhibitor prescribing was low. Conclusions We successfully used electronic health record data from 18 PCORnet data marts to identify >3.6 million patients meeting criteria for 3 patient groups. Approximately half of patients had been prescribed lipid-lowering medication, but <1% were prescribed PCSK9 inhibitors. PCSK9 inhibitor prescribing increased over time for patients with coronary artery disease or coronary heart disease but not for those with dyslipidemia.

AB - Background PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors effectively lower LDL (low-density lipoprotein) cholesterol and have been shown to reduce cardiovascular outcomes in high-risk patients. We used real-world electronic health record data to characterize use of PCSK9 inhibitors, in addition to standard therapies, according to cardiovascular risk status. Methods and Results Data were obtained from 18 health systems with data marts within the National Patient-Centered Clinical Research Network (PCORnet) using a common data model. Participating sites identified >17.5 million adults, of whom 3.6 million met study criteria. Patients were categorized into 3 groups: (1) dyslipidemia, (2) untreated LDL ≥130 mg/dL, and (3) coronary artery disease or coronary heart disease. Demographics, comorbidities, estimated 10-year atherosclerotic cardiovascular disease risk, and lipid-lowering pharmacotherapies were summarized for each group. Participants' average age was 62 years, 50% were female, and 11% were black. LDL cholesterol ranged from 85 to 151 mg/dL. Among patients in groups 1 and 3, 54% received standard lipid-lowering therapies and a PCSK9 inhibitor was prescribed in <1%. PCSK9 inhibitor prescribing was greatest for patients with coronary artery disease or coronary heart disease and, although prescribing increased during the study period, overall PCSK9 inhibitor prescribing was low. Conclusions We successfully used electronic health record data from 18 PCORnet data marts to identify >3.6 million patients meeting criteria for 3 patient groups. Approximately half of patients had been prescribed lipid-lowering medication, but <1% were prescribed PCSK9 inhibitors. PCSK9 inhibitor prescribing increased over time for patients with coronary artery disease or coronary heart disease but not for those with dyslipidemia.

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KW - lipids

KW - PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor

KW - secondary prevention

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