About half of patients with cardiovascular disease (CVD) may be eligible for proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitor therapy and results from a study of a large Canadian population-based cohort show such therapy may prevent CV events, though with significant costs. [Ko DT, et al, AHA 2017, abstract 778]

Among 62,729 adult patients with CVD, 61 percent, or 2.6 percent of the general population, were eligible for PCSK9 inhibitors based on eligibility criteria of the FOURIER trial (ie, fasting LDL-cholesterol ≥70 mg/dL or non–HDL-cholesterol ≥100 mg/dL while on an optimized lipid-lowering regimen).

“Applying the FOURIER hazard ratio to our study, we found a reduction in primary outcome [CV death, MI, unstable angina, stroke or coronary revascularization] of about 1.3 percent with PCSK9 inhibitors, which is similar to results of the FOURIER study,” said lead researcher Dr Dennis Ko of the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada. 

“This was associated with a high cost per event,” he added, noting that the anticipated absolute clinical benefit in their trial may be smaller than reported in other PCSK9 inhibitor trials because of low overall event rates.