ArticleCureus2025
Prescribing Patterns of Evolocumab and Alirocumab in Patients With Familial Hypercholesterolemia: A Cross-Sectional Study Using the National Ambulatory Medical Care Survey, 2018-2019.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFamilial hypercholesterolemia (FH) is a hereditary lipid disorder that substantially elevates cardiovascular risk. Despite strong evidence and guideline recommendations, the real-world use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in FH remains uncertain.
objectiveThis study aimed to evaluate national trends in PCSK9 inhibitor prescribing during ambulatory visits for adults with FH in the United States from 2018 to 2019.
methodsWe conducted a cross-sectional analysis of ambulatory care visits recorded in the 2018-2019 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of office-based physicians in the United States. Eligible visits included adults (≥18 years) with a diagnosis of FH (International Classification of Diseases, 10
resultsAmong the weighted total of 20,414,210 visits for adults with FH, only 69,672 visits (0.3%) included a prescription for a PCSK9 inhibitor. Prescribing was observed exclusively among female, White patients and occurred almost entirely in primary care settings. Patients receiving PCSK9 therapy were older than those not prescribed (mean 71.0 vs. 66.5 years, p=0.004). No prescribing was observed among males, racial/ethnic minority groups, or patients seen in surgical or medical specialties. In survey-weighted logistic regression, each additional year of age was associated with a 4% higher odds of PCSK9 prescribing (OR 1.04, 95% CI: 1.02-1.07, p=0.002).
conclusionPCSK9 inhibitor use in FH patients during U.S. ambulatory visits was rare, highlighting a persistent gap between evidence-based guidelines and clinical practice. Broader adoption strategies are needed to optimize lipid management and reduce cardiovascular risk in FH.
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