Lipid profile of patients treated with evolocumab in Spanish hospital nephrology units (RETOSS NEFRO)
Por:
Goicoechea M, Álvarez V, Segarra A, Polaina M, Martín-Reyes G, Robles NR, Escudero V, Orellana C, Bea Granell S, de Juan-Ribera J, Fernández Lucas M, Graña JM, Reque J, Sánchez Hernández R, Villamayor S and Górriz JL
Publicada:
1 may 2022
Ahead of Print:
1 may 2022
Resumen:
Background and objective: To describe the clinical characteristics, the reasons for initiating therapy and the effects of treatment in the initial phase of evolocumab availability in the Nephrology Units of Spain.
Material and methods: Retrospective, observational and multicentric study that included patients initiating treatment with evolocumab (from February 2016 to August 2018), in 15 Nephrology Units in Spain. The demographic and clinical characteristics of the patients, the lipid lowering treatment and the evolution of the lipid profiles between 24 weeks pre-initiation and 12 +/- 4 weeks post-initiation of evolocumab were reviewed.
Results: Sixty patients were enrolled: 53.3% women; mean (SD) age, 56.9 (12.8) years, 45.0% with familial hypercholesterolemia (FH) (5.0% homozygous and 40.0% heterozygous) and 65.0% with atherosclerotic cardiovascular (CV) disease. The mean (SD) eGFR was 62.6 (30.0) ml/min/1.73 m(2) (51.7% of patients had eGFR < 60 ml/min/1.73 m(2) [CKD stage > 2]), 50.0% had proteinuria (>300 mg/g) and 10.0% had nephrotic syndrome. Other CV risk factors were hypertension (75.0%), diabetes (25.0%), and smoking (21.7%). A 40.0% of patients were statin intolerant. At evolocumab initiation, 41.7% of patients were on a high-intensity statin, 18.3% on moderate intensity statin and 50.0% were receiving ezetimibe. Mean (SD) LDL-c at evolocumab initiation was 179.7 (62.9) mg/dL (53.4% of patients with LDL-c >= 160 mg/dL and 29.3%>= 190 mg/dL). After 12 weeks, evolocumab resulted in LDL-c reductions of 60.1%. At week 12, 90.0% of patients reached LDL-c levels <100 mg/dL, 70.0% <70 mg/dL, and 55.0% <55 mg/dL, while mean eGFR levels and statin use were remained stable.
Conclusion: In Nephrology Units of Spain, evolocumab was predominantly prescribed in patients with FH, chronic renal disease (CRD>2) and secondary prevention, with LDL-c levels above those recommended by the guidelines. Evolocumab used in clinical practice significantly reduced the LDL-c levels in all patients included in the study. (C) 2021 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
Filiaciones:
Goicoechea M:
Servicio de Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España
Álvarez V:
Servicio de Nefrología, Hospital Universitario de La Princesa, Madrid, España
Segarra A:
Servicio de Nefrología, Hospital Arnau de Vilanova, Lérida, España
Polaina M:
Servicio de Nefrología, Complejo Hospitalario de Jaén, Jaén, España
Martín-Reyes G:
Unidad de Gestión Clínica de Nefrología, Hospital Regional Universitario, Universidad de Málaga, Málaga, España
Servicio de Nefrología, IBIMA, REDinREN (RD16/0009/0006), Málaga, España
Robles NR:
Servicio de Nefrología, Hospital Universitario de Badajoz, Badajoz, España
:
Servicio de Nefrología, Hospital Universitario Dr. Peset, Valencia, España
Orellana C:
Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España
Bea Granell S:
Servicio de Nefrología, Consorcio Hospital General Universitario de Valencia, Valencia, España
:
Servicio de Nefrología, Hospital General Universitario de Elda, Elda, Alicante, España
Fernández Lucas M:
Servicio de Nefrología, Hospital Universitario Ramón y Cajal, Madrid, España
:
Servicio de Nefrología, Hospital Universitario de la Ribera, Alzira, Valencia, España
:
Servicio de Nefrología, Hospital Rey Don Jaime, Castellón, España
Sánchez Hernández R:
Servicio de Nefrología, Hospital Universitario General de Villalba, Villalba, Madrid, España
Villamayor S:
Departamento Médico, Amgen España, Barcelona, España
Górriz JL:
Servicio de Nefrología, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, España
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