PCSK-9 Inhibitors Treatment: The Cardiovascular Disparity
Location
Philadelphia, PA
Start Date
30-4-2025 1:00 PM
End Date
30-4-2025 4:00 PM
Description
Introduction: According to the Center for Disease Control and Prevention (CDC) and American Heart Association (AHA), cardiovascular disease is the leading cause of death in the United States. This phenomenon disproportionally affects the African American population, who have a 32% higher mortality rate than non-Hispanic Caucasian individuals. A retrospective review of PCSK-9 medication use, specifically in a patient population that had minimal representation in the large, landmark clinical trials, can lead to better understanding about the therapeutic potential in cardiovascular disease reduction and patient outcomes attributed to medication use. Education regarding this novel drug class, medication access and patient support, and the cardiovascular implications of uncontrolled LDL-C will be necessary to reduce the significant morbidity and mortality currently present.
Methods: A retrospective analysis of patients who identify as African American and
were prescribed a PCSK-9 inhibitor, as well as all patient populations who were prescribed a
PCSK-9 inhibitor since January 1, 2015 through September 12, 2024 was conducted within a health system with three primary care practice clinics in an urban community in a major metropolitan city. A survey using Likert scale questions was distributed December 5, 2024 to twenty-one primary care physicians. A Continuing Medical Education-accredited presentation on this pharmacologic class was presented December 13, 2024. A post-intervention survey was distributed after the educational intervention. Both pre- and post- intervention survey results were analyzed January 2025. A paired sample t-test and Cohen’s d analyses were applied for outcome statistical analysis.
Results: Of the 6,521 patients who had a current diagnosis of hyperlipidemia including all patient demographics, only five patients were prescribed a PCSK-9 inhibitor medication. Four patients identified as African American and one patient identified as Caucasian. All five patients identified as female. Although there was significant LDL-C reduction and total cholesterol reduction compared to baseline, there is insufficient data to draw appropriate conclusions due to low medication utilization and lack of patient follow-up. Six of twenty-one physicians completed both the pre- and post-intervention survey. Pre- and post-intervention survey analysis revealed a statistically significant difference between the providers’ responses regarding their concerns/questions about prescribing a PCSK-9 inhibitor and understanding the necessary documentation for medication approval through insurance (p = 0.022, p = 0.038 respectively). The effect size in survey responses is considered large for both significant findings (Cohen’s d = 1.088 and 0.913, respectively).
Conclusion: Further studies are necessary to evaluate the potential benefits of PCSK-9 medication use in patient populations at significant risk of cardiovascular disease within the United States. Interdisciplinary collaboration involving clinical pharmacists within primary care management is necessary to reduce the existing barriers that patients face regarding medication access as well as support prescribing practitioners to achieve optimal patient outcomes regarding chronic disease management.
Embargo Period
5-20-2025
PCSK-9 Inhibitors Treatment: The Cardiovascular Disparity
Philadelphia, PA
Introduction: According to the Center for Disease Control and Prevention (CDC) and American Heart Association (AHA), cardiovascular disease is the leading cause of death in the United States. This phenomenon disproportionally affects the African American population, who have a 32% higher mortality rate than non-Hispanic Caucasian individuals. A retrospective review of PCSK-9 medication use, specifically in a patient population that had minimal representation in the large, landmark clinical trials, can lead to better understanding about the therapeutic potential in cardiovascular disease reduction and patient outcomes attributed to medication use. Education regarding this novel drug class, medication access and patient support, and the cardiovascular implications of uncontrolled LDL-C will be necessary to reduce the significant morbidity and mortality currently present.
Methods: A retrospective analysis of patients who identify as African American and
were prescribed a PCSK-9 inhibitor, as well as all patient populations who were prescribed a
PCSK-9 inhibitor since January 1, 2015 through September 12, 2024 was conducted within a health system with three primary care practice clinics in an urban community in a major metropolitan city. A survey using Likert scale questions was distributed December 5, 2024 to twenty-one primary care physicians. A Continuing Medical Education-accredited presentation on this pharmacologic class was presented December 13, 2024. A post-intervention survey was distributed after the educational intervention. Both pre- and post- intervention survey results were analyzed January 2025. A paired sample t-test and Cohen’s d analyses were applied for outcome statistical analysis.
Results: Of the 6,521 patients who had a current diagnosis of hyperlipidemia including all patient demographics, only five patients were prescribed a PCSK-9 inhibitor medication. Four patients identified as African American and one patient identified as Caucasian. All five patients identified as female. Although there was significant LDL-C reduction and total cholesterol reduction compared to baseline, there is insufficient data to draw appropriate conclusions due to low medication utilization and lack of patient follow-up. Six of twenty-one physicians completed both the pre- and post-intervention survey. Pre- and post-intervention survey analysis revealed a statistically significant difference between the providers’ responses regarding their concerns/questions about prescribing a PCSK-9 inhibitor and understanding the necessary documentation for medication approval through insurance (p = 0.022, p = 0.038 respectively). The effect size in survey responses is considered large for both significant findings (Cohen’s d = 1.088 and 0.913, respectively).
Conclusion: Further studies are necessary to evaluate the potential benefits of PCSK-9 medication use in patient populations at significant risk of cardiovascular disease within the United States. Interdisciplinary collaboration involving clinical pharmacists within primary care management is necessary to reduce the existing barriers that patients face regarding medication access as well as support prescribing practitioners to achieve optimal patient outcomes regarding chronic disease management.