Possibilities of different modes of evocolumab administration in real clinical practice according to the experience of the regional lipid center in cardiology dispensary of City Clinical Hospital № 5 in Nizhny Novgorod

Abstract

Purpose of the study: to evaluate the results of using different modes of evocolumab administration and their effect on adherence to therapy in a real clinical setting.
Materials and Methods: 34 patients with poor control of dyslipidemia observed, who initiated treatment with evolocumab at the regional lipid center. The drug initially administered at 140 mg once every 2 weeks. By the decision of the doctor and taking into account the opinion of the patient, in the future, 21 patients transferred to an alternative treatment regimen (420 mg once a month). Patients who continued therapy in the "140 mg once every 2 weeks" regimen followed up for 2 months. Similarly, patients who switched to the 420 mg once a month regimen continued followed up for another 2 months. Before each injection of evolocumab, the number of patients with LDL cholesterol in the target range and the number of people who did not come on time (delayed injection considered as an indicator of insufficient adherence to treatment) assessed.
Results. The use of evolocumab in the "140 mg every 2 weeks" and "420 mg every month" regimens achieves an LDL cholesterol level of ≤1.4 mmol / L in more than 70% of cases. Difficulties in achieving the target LDL cholesterol may partly be associated with a violation of the timing of drug administration (4.8% – 31.6% of cases). For 2 months, among patients receiving treatment according to the "140 mg every 2 weeks" scheme, a total of 96 visits were carried out, of which 23 (24%) were 1–4 days late. During the same time period after switching to the 420 mg every month scheme, 42 visits were carried out, including 4 (9.5%) – with a delay, which indicates a decrease in the percentage of “delayed” visits by more than 2.5 times (р = 0.037).
Conclusion. Evolocumab, 140 mg every 2 weeks and 420 mg every month, is highly effective and achieves target LDL cholesterol levels in more than 70% of cases. The introduction of evolocumab according to the "420 mg every month" scheme in real clinical practice can be more comfortable for the patient and increase adherence to therapy. The transition of patients to this scheme is associated with a decrease in the percentage of "deferred" injections by more than 2.5 times.