Trends in Lipid Lowering Prescriptions: Increasing Use of Guideline Concordant Pharmacotherapies — U.S., 2017–2022

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Sekkarie, Ahlia ; Park, Soyoun ; Therrien, Nicole L. ; Jackson, Sandra L. ; Woodruff, Rebecca C. ; Attipoe-Dorcoo, Sharon ; Yang, Peter K. ; Sperling, Laurence ; Loustalot, Fleetwood ; Thompson-Paul, Angela M.
• Description:
  Introduction:
  
  Almost one-third of U.S. adults have elevated low-density lipid cholesterol (LDL-C) increasing their risk of atherosclerotic cardiovascular disease (ASCVD). The 2018 American College of Cardiology/American Heart Association Multisociety Cholesterol Management Guideline recommends maximally tolerated statin for those at increased ASCVD risk and add-on therapies (ezetimibe and PCSK9 inhibitors) in those at very high risk and an LDL-C≥70mg/dl. Prescription fill trends are unknown.
  
  Methods:
  
  Using national outpatient retail prescription data from Q1 2017–Q1 2022, authors determined counts of patients who filled who filled low-, moderate-, or high-intensity statins alone and with add-on therapies. Overall percent change and joinpoint regression were used to assess trends. Analyses were conducted March‒May 2022.
  
  Results:
  
  During Q1 2017–Q1 2022, patients filling a statin increased 25.0%, with the greatest increase in high-intensity statins (64.1%, 6.6–10.9 million). Low-intensity statins decreased 29.2% (3.3–2.4 million). Concurrent fills of high-intensity statin and ezetimibe rose 210% to 579,012 patients by Q1 2022, with an increase in slope by Q1 2019 for all statin intensities (p<0.01). Concurrent fills of a statin and PCSK9 inhibitor increased to 2,629, 16,169, and 28,651 by Q1 2022 for low-, moderate- and high-intensity statins, respectively. For patients on all statin intensities and PCSK9 inhibitor there were statistically significant increases in slope in Q2 2019 and decreases in Q1 2020.
  
  Conclusions:
  
  Patients filling moderate- and high-intensity statins and add-on ezetimibe, and PCSK9 inhibitors have increased, indicating uptake of guideline-concordant lipid-lowering therapies. Improvements in initiation and continuity of these therapies are important for ASCVD prevention.
  
  
• Subjects:
  Adult Atherosclerosis Cardiovascular Diseases Cholesterol Cholesterol, LDL Ezetimibe Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors PCSK9 Inhibitors Prescriptions Proprotein Convertase 9

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• Source:
  Am J Prev Med. 64(4):561-566
• Pubmed ID:
  36464556
• Pubmed Central ID:
  PMC10033441
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  64
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3072c73c63b5a51fb68caa6167bbcd6c139ded561f014c8ee033eb22332415f6
• Download URL:
  https://stacks.cdc.gov/view/cdc/126185/cdc_126185_DS1.pdf
• File Type:
  [PDF - 1.09 MB ]