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- Title
Simulation of bempedoic acid and ezetimibe in the lipid-lowering treatment pathway in Austria using the contemporary SANTORINI cohort of high and very high risk patients.
- Authors
Toplak, Hermann; Bilitou, Aikaterini; Alber, Hannes; Auer, Johann; Clodi, Martin; Ebenbichler, Christoph; Fließer-Görzer, Evelyn; Gelsinger, Carmen; Hanusch, Ursula; Ludvik, Bernhard; Maca, Thomas; Schober, Andreas; Sock, Reinhard; Speidl, Walter S.; Stulnig, Thomas M.; Weitgasser, Raimund; Zirlik, Andreas; Koch, Marina; Wienerroither, Sebastian; Wolowacz, Sorrel E.
- Abstract
Summary: Objective: The low-density lipoprotein cholesterol goals in the 2019 European Society of Cardiology/European Atherosclerosis Society dyslipidaemia guidelines necessitate greater use of combination therapies. We describe a real-world cohort of patients in Austria and simulate the addition of oral bempedoic acid and ezetimibe to estimate the proportion of patients reaching goals. Methods: Patients at high or very high cardiovascular risk on lipid-lowering treatments (excluding proprotein convertase subtilisin/kexin type 9 inhibitors) from the Austrian cohort of the observational SANTORINI study were included using specific criteria. For patients not at their risk-based goals at baseline, addition of ezetimibe (if not already received) and subsequently bempedoic acid was simulated using a Monte Carlo simulation. Results: A cohort of patients (N = 144) with a mean low-density lipoprotein cholesterol of 76.4 mg/dL, with 94% (n = 135) on statins and 24% (n = 35) on ezetimibe monotherapy or in combination, were used in the simulation. Only 36% of patients were at goal (n = 52). Sequential simulation of ezetimibe (where applicable) and bempedoic acid increased the proportion of patients at goal to 69% (n = 100), with a decrease in the mean low-density lipoprotein cholesterol from 76.4 mg/dL at baseline to 57.7 mg/dL overall. Conclusions: The SANTORINI real-world data in Austria suggest that a proportion of high and very high-risk patients remain below the guideline-recommended low-density lipoprotein cholesterol goals. Optimising use of oral ezetimibe and bempedoic acid after statins in the lipid-lowering pathway could result in substantially more patients attaining low-density lipoprotein cholesterol goals, likely with additional health benefits.
- Subjects
AUSTRIA; SANTORINI Island (Greece); EUROPEAN Society of Cardiology; LDL cholesterol; EZETIMIBE; MONTE Carlo method
- Publication
Wiener Klinische Wochenschrift, 2023, Vol 135, Issue 13/14, p364
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-023-02221-4