Patient adherence, compliance, and perspectives on evolocumab for the management of resistant hypercholesterolemia

Constantine E Kosmas,1 Delia Silverio,2 Julio Ovalle,2 Peter D Montan,2 Eliscer Guzman3 1Division of Cardiology, Department of Medicine, Mount Sinai Hospital, New York, NY, USA; 2Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA; 3Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA Abstract: Evolocumab is a PCSK9 inhibitor which is administered subcutaneously, and when added to statin therapy it has been shown to cause a significant incremental LDL-C reduction, leading to a reduction of cardiovascular risk. Evolocumab has a favorable side effect profile, and its self-administration at home appears to be safe and effective with the appropriate training and instructions from a health care provider. Current studies are showing encouraging results regarding adherence to evolocumab in real-life settings, and adherence rates to evolocumab appear to be better than those to statins. However, further larger studies are needed for a more definitive assessment of the short- and long-term patient adherence rates to evolocumab. In addition, reductions in the price of evolocumab may also be necessary to improve cost-effectiveness of the drug. Keywords: evolocumab, adherence, hypercholesterolemia, cardiovascular risk