Uptake of non-statin lipid-lowering therapies for secondary prevention in community practice

Nearly two-thirds of individuals with atherosclerotic cardiovascular disease (ASCVD) do not reach target low-density lipoprotein cholesterol despite statin therapy. Three novel lipid-lowering therapies have proven to further reduce ASCVD beyond statins, including: ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), and icosapent ethyl. This study evaluated the use of these three agents in 728,423 individuals with ASCVD from 89 US health systems from 01/2018 through 03/2021 using the electronic health record. As of 2021, only 6.0% of ASCVD patients were on ezetimibe, 1.6% were on a PCSK9i, and 1.3% on icosapent ethyl, with utilization only marginally increasing over the study period. Addressing the underutilization of non-statin lipid-lowering therapy for secondary prevention is a critical step in improving the treatment gap of patients with residual risk of ASCVD.& COPY; 2023 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Automated summary

Nearly two-thirds of individuals with atherosclerotic cardiovascular disease (ASCVD) fail to reach target low-density lipoprotein cholesterol levels despite statin therapy. Three novel lipid-lowering therapies, including ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), and icosapent ethyl, have been proven to further reduce ASCVD. However, the utilization rates of these therapies are low, highlighting the need to address the underutilization of non-statin lipid-lowering therapy.