{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:33:35Z","timestamp":1781825615900,"version":"3.54.5"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,5]]},"abstract":"\n Background<\/jats:title>\n \n Proprotein convertase subtilisin\/kexin type 9 inhibitors (\n PCSK<\/jats:styled-content>\n 9i) are used to reduce low\u2010density lipoprotein (\n LDL<\/jats:styled-content>\n ) cholesterol.\n PCSK<\/jats:styled-content>\n 9i use after initiation, as well as persistence with or alterations to other\n LDL<\/jats:styled-content>\n \u2010lowering therapy after\n PCSK<\/jats:styled-content>\n 9i initiation, is not well understood.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We conducted a retrospective study of alirocumab or evolocumab (\n PCSK<\/jats:styled-content>\n 9i) new users from July 2015 to December 2017 in the MarketScan Early View database of US commercial insurance beneficiaries. We determined the prevalence of\n PCSK<\/jats:styled-content>\n 9i interruption (\u226530\u2010day gap in supply) and\n LDL<\/jats:styled-content>\n \u2010lowering therapy use in the year after\n PCSK<\/jats:styled-content>\n 9i initiation. The average age of 6151 patients initiating\n PCSK<\/jats:styled-content>\n 9i therapy was 63\u00a0years, 44.4% were women, and 76.8% had atherosclerotic cardiovascular disease. Overall, 52.2% (95%\n CI<\/jats:styled-content>\n , 50.8%\u201353.7%) of patients had an interruption in\n PCSK<\/jats:styled-content>\n 9i therapy in the first year after treatment initiation and 62.5% remained on\n PCSK<\/jats:styled-content>\n 9i therapy at 1\u2010year postinitiation. Also, 27.7% of patients were taking a statin at the time of\n PCSK<\/jats:styled-content>\n 9i initiation, with only 22.4% on statin therapy at 1\u00a0year after\n PCSK<\/jats:styled-content>\n 9i initiation. Ezetimibe use decreased from 20.9% at the time of\n PCSK<\/jats:styled-content>\n 9i initiation to 12.0% a year later. By 1\u00a0year after\n PCSK<\/jats:styled-content>\n 9i initiation, 44.0% of patients had experienced an interruption in all\n LDL<\/jats:styled-content>\n \u2010lowering therapies, and 26.6% were no longer on any\n LDL<\/jats:styled-content>\n \u2010lowering therapies.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n After\n PCSK<\/jats:styled-content>\n 9i initiation, statins were often discontinued, whereas more than half of patients experienced an interruption in\n PCSK<\/jats:styled-content>\n 9i therapy. These results suggest that many new\n PCSK<\/jats:styled-content>\n 9i users may remain at high risk for cardiovascular events because of interruptions in\n LDL<\/jats:styled-content>\n \u2010lowering therapy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.014347","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T09:01:05Z","timestamp":1587718865000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Use of Low\u2010Density Lipoprotein\u2013Lowering Therapies Before and After PCSK9 Inhibitor Initiation"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-2393","authenticated-orcid":false,"given":"Jennifer A.","family":"Rymer","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Mues","sequence":"additional","affiliation":[{"name":"Center for Observational Research Amgen Inc Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keri L.","family":"Monda","sequence":"additional","affiliation":[{"name":"Center for Observational Research Amgen Inc Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily W.","family":"Bratton","sequence":"additional","affiliation":[{"name":"IQVIA, Real\u2010World Evidence Solutions Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi S.","family":"Wirtz","sequence":"additional","affiliation":[{"name":"Center for Observational Research Amgen Inc Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted","family":"Okerson","sequence":"additional","affiliation":[{"name":"Center for Observational Research Amgen Inc Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Overman","sequence":"additional","affiliation":[{"name":"NoviSci, Inc Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Alan","family":"Brookhart","sequence":"additional","affiliation":[{"name":"NoviSci, Inc Durham NC"},{"name":"University of North Carolina at Chapel Hill Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Muntner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Alabama at Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","unstructured":"FDA Approval of Evolocumab . Available at: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/125522s014lbl.pdf. 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PCSK9 inhibitors for treatment of high cholesterol: effectiveness value and value\u2010based price benchmarks. Institute for Clinical and Economic Review. https:\/\/icer-review.org\/wp-conte\u200bnt\/uploa\u200bds\/2016\/01\/Final-Report-for-Posti\u200bng-11-24-15-1.pdf. Accessed September 29 2018."},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3182a7fc3d"},{"key":"e_1_3_1_23_2","first-page":"1208","article-title":"Geospatial analysis of statin adherence using pharmacy claims data in the state of Michigan","volume":"20","author":"Erickson SR","year":"2014","unstructured":"Erickson SR, Lin YN. Geospatial analysis of statin adherence using pharmacy claims data in the state of Michigan. J Manag Care Spec Pharm. 2014;20:1208\u20131215.","journal-title":"J Manag Care Spec Pharm"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-012-0291-7"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.03.019"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.4936"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3970"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.014347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:08:12Z","timestamp":1715598492000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.014347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":27,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,5,5]]}},"alternative-id":["10.1161\/JAHA.119.014347"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.014347","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,5]]},"assertion":[{"value":"2020-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e014347"}}