According to results of a retrospective chart review, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are both well tolerated as well as effective in adult patients who reported being intolerant to statin therapy.

The study utilized patient-reported side effects to determine the tolerability of the PCSK9 inhibitors evolocumab and alirocumab. Secondary study objectives included efficacy and obtainability, which were evaluated using laboratory results and insurance information.

Results of the study found that of the 55 patients who were prescribed evolocumab or alirocumab during the study period, 42 initiated therapy and 34 had ≥1 follow-up visit. “While myalgias occurred in 14.7% (N=5) of patients, flu-like symptoms in 11.8% (N=4), and fatigue in 2.9% (N=1), only 5.9% (N=2) of prescriptions for PCSK9 inhibitors were discontinued,” the authors reported.

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Efficacy data revealed that use of a PSCK9 inhibitor led to a 48.7% reduction in low-density lipoprotein cholesterol (LDL-C) (95% CI: -1.7%, 99.1%). Additionally, study results showed that 58.8% (N=20) of patients attained a ≥50% reduction in LDL-C. The study authors also reported, “Regarding obtainability, of the 57 prescriptions written, 77.2% (N=44) required prior authorization and 5.3% (N=3) were denied by insurance.”

According to the results of this retrospective review, PCSK9 inhibitors are both effective and well tolerated among patients with statin intolerance.


Davidson ER, Snider MJ, Bartsch K. Tolerance of proprotein convertase subtilisin/kexin type 9 inhibitors in patients with self-reported statin intolerance. Journal of Pharmacy Practice. 2018.