Safety and Effectiveness of Alirocumab, a Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor, in Patients With Familial or Non-Familial Hypercholesterolemia - A Post-Marketing Survey (J-POSSIBLE)

Circ J. 2023 May 25;87(6):834-846. doi: 10.1253/circj.CJ-22-0445. Epub 2023 Jan 11.

Abstract

Background: This study evaluated the safety and effectiveness of alirocumab in Japanese patients with familial hypercholesterolemia (FH) or non-FH in a real-world clinical setting.Methods and Results: This post-marketing surveillance study had a 2-year standard observation period. The study included Japanese patients with hypercholesterolemia who were treatment naïve to alirocumab, had a high risk of developing cardiovascular events, and had an insufficient response to, or were unsuitable for, treatment with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Alirocumab was administered at a dose of 75 or 150 mg via subcutaneous injection every 2 or 4 weeks. Overall, 1,177 and 1,038 patients were included in the safety and effectiveness analysis populations, respectively. The incidence of adverse drug reactions (ADRs) was 3.4% (40/1,177). The time to ADR occurrence was within 4 weeks in half the patients experiencing ADRs (n=20). There were no meaningful differences in the ADRs experienced in the FH and non-FH groups. The mean (±SE) percentage changes in low-density lipoprotein cholesterol from baseline to last observation carried forward were -46.9±2.1% and -42.7±2.0% in the non-FH and FH groups, respectively. Total cholesterol, triglycerides, apolipoprotein B/E, and lipoprotein(a) concentrations were decreased at Week 4 and maintained until Week 104 in the overall population.

Conclusions: Alirocumab was well tolerated and showed effectiveness in Japanese patients with hypercholesterolemia in a real-world clinical setting.

Keywords: Alirocumab; Familial hypercholesterolemia; Lipid-lowering therapy; PCSK9 inhibitor; Post-marketing survey.

MeSH terms

  • Anticholesteremic Agents* / adverse effects
  • Antiviral Agents / therapeutic use
  • Cholesterol, LDL
  • Double-Blind Method
  • Humans
  • Hypercholesterolemia* / drug therapy
  • Hyperlipidemias*
  • Hyperlipoproteinemia Type II* / drug therapy
  • Proprotein Convertase 9
  • Subtilisins / therapeutic use
  • Treatment Outcome

Substances

  • alirocumab
  • PCSK9 protein, human
  • Proprotein Convertase 9
  • Cholesterol, LDL
  • Antiviral Agents
  • Subtilisins
  • Anticholesteremic Agents