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LDL lowering more robust in men vs. women in concomitant PCSK9 inhibitor, statin therapy
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PHILADELPHIA — In a small cohort of patients taking PSCK9 inhibitors, men had a lower reduction in LDL than women among those also on statin therapy, according to a poster presented at the National Lipid Association Scientific Sessions.
Debra Friedrich, DNP, FNP-BC, CLS, BC-ADM, FNLA, FACC, assistant professor at University of South Florida College of Nursing, Tampa, and colleagues analyzed 97 patients at five lipid clinics.
The primary endpoint was sex differences in LDL lowering due to PCSK9 inhibition. Secondary endpoints included sex differences in LDL lowering stratified by tolerated statin dose, by age and by baseline LDL levels. For all analyses, the researchers calculated sex differences in LDL lowering by individual agent — alirocumab (Praluent, Sanofi/Regeneron) and evolocumab (Repatha, Amgen) — and by an aggregate of all agents.
For the entire cohort, LDL was lowered by 61.4% in men vs. 49.1% in women, Friedrich and colleagues found.
Among those taking alirocumab, LDL was lowered by 54.4% in men vs. 43.3% in women, and among those taking evolocumab, LDL was lowered by 66.7% in men and 55% in women, according to the results.
The results were consistent by age except in the oldest cohort, though there were too few patients in each age group to determine statistical significance, Friedrich and colleagues found.
The sex differences persisted regardless of baseline LDL, but they were only observed in patients on concomitant statin therapy.
“When we look at patients who are just on PSCK9 inhibition or just on statin therapy, there is no difference in LDL reduction between men and women, but when you combine statins and PCSK9 inhibition, we start to see a gender-related change, and men have a more robust LDL lowering than women,” Friedrich told Cardiology Today.
It is not known why concomitant therapy affects the sexes differently, and more studies are needed to determine that, Friedrich said.
“We need a funded study with a larger sample,” she said. “We used five lipid clinics in Florida for these data, but we need to expand that to get … a more robust population.” – by Erik Swain
Reference:
Friedrich D, et al. Abstract 173. Presented at: National Lipid Association Scientific Sessions; May 18-21, 2017; Philadelphia.
Disclosure: Friedrich reports no relevant financial disclosures.