S.FARIHA1, S.L.T.PEK1, H.Y.WONG1, S.DISSANAYAKE1, D.T.E.CHIN1, C.C.P.WONG1, J.I.S.TANG1, W.Y.WAN1, J.Z.TAN1, S.C.LIM1, C.F.SUM2
Khoo Teck Puat Hospital1, Admiralty Medical Centre2
Elevated low-density lipoprotein cholesterol(LDL-C) is a risk factor for coronary heart disease(CHD). Although statins offer good LDL-C lowering effects, there are limitations such as treatment resistance, sub-optimal lowering and statin-intolerance.
Proprotein convertase subtilisin / kexin type 9 inhibitors(PCSK9i) can further reduce LDL-C and risk of CHD by inhibiting PCSK9 enzyme. Impact on quality of life(QOL) in patients taking PCSK9i is unknown locally. We aim to assess QOL on patients on PCSK9i.
Patients with LDL-C ≥2.6mmol/l with pre-existing CHD or LDL-C>3.4mmol/l with moderate risk of CHD were recruited from Endocrinology and Cardiology clinics. Patients were started on PCSK9i and followed up for 52 weeks (5 visits).
Treatment Satisfaction Questionnaire for Medication(TSQM-1.4) and Health-Related QoL(HRQoL)(EQ-5D-5L) questionnaire were administered at visit 1(V1: week 0) and visit 5(V5: week 52). Paired t-test and Wilcoxon signed-rank test for V1 versus V5, were analysed by Statistical Package for Social Sciences(SPSS).
Twenty-one patients were recruited. Mean age: 54.6(±9.6)years, BMI: 25.6(±3.5)kg/m2, 16(76.2%)males; Ethnicity: 14(66.7%)Chinese, 6(28.6%)Malay; 10(47.7%) had genetically confirmed Familial Hypercholesterolemia and 12(57.5%) pre-existing CHD. To-date:16 patients completed 5 visits(52 weeks), 17 completed 4 visits(36 weeks) and 1 patient stopped PCSK9i(non-response).
Total cholesterol(TC) and LDL-C(mmol/l)(V1vsV5): 5.78(4.79-6.59) vs 3.16(2.51-3.86), p=0.001 and 4.16(2.99-5.24) vs 1.60(1.12-2.24), p=0.001, respectively.
TSQM(V1vsV5) on Effectiveness(EF), Side-Effect(SE), Convenience(CON), Overall Satisfaction(OS) were 50.0(33.3-66.7) vs 80.5(66.7-83.3),p=0.02, 43.8(±10.2),p=0.003, -0.35(±20.6),p=0.947 and 20.0(±11.5),p<0.001, respectively. No significant difference was found in EQ-5D-5L (V1vsV5) scores.
Patients had significant reduction in cholesterols and were more satisfied with PCSK9i prescriptions with no significant impact on their QOL in terms of several aspects assessed.