Burden Of Cardiovascular Disease (CVD) For Patients With Familial Hypercholesterolemia (FH) Or Atherosclerotic Cardiovascular Disease (ASCVD) And The Impact Of Reducing Low Density Lipoprotein-Cholesterol (LDL-C) Lowering In Latin American Countries

OBJECTIVES: To estimate the burden of CVD and impact of LDL-C lowering in patients with FH or ASCVD with uncontrolled LDL-C levels in Mexico, Colombia, and Brazil. METHODS: The number of statin-treated patients with FH or ASCVD with uncontrolled LDL-C≥100mg/dL (≥2.6 mmol/L) in Mexico, Colombia, and Brazil was estimated based on country population and estimated disease prevalence. The clinical benefits of evolocumab as an add-on therapy to statins were derived from a long-term cardiovascular outcomes study (FOURIER) and the Cholesterol TYeatment Trialists' Collaboration, a large meta-analysis of statins outcomes trials, modeled over a lifetime to determine the impact on CV events, hospitalization costs, and quality adjusted life years (QALY). RESULTS: The number of statin-treated patients with FH or ASCVD with uncontrolled LDL-C was estimated at 0.15-0.37 million FH and 2.85 million ASCVD patients with uncontrolled LDL-C in Mexico; approximately 0.29-073 million FH and 2.5 million ASCVD patients in Brazil; approximately 0.06-0.15million FH and 0.50 million ASCVD patients in Colombia. Over the lifetime of an individual with FH, the additional LDL-C lowering with evolocumab is projected to result in a 0.52 (28%) CVD event reduction, and an increase in 3.26 QALY The cost of hospitalization may decrease by $5,377USD in Mexico, $3,468USD in Colombia, $612 in Brazil. Similarly, over the lifetime of an individual with ASCVD, evolocumab was projected to result in a 0.44 (23%) CVD event reduction, and an increase in 1.84 QALY. For ASCVD patients, the cost of hospitalization may decrease by $4,603USD in Mexico, $2,883USD in Colombia, $512USD in Brazil. CONCLUSIONS: CVD burden is significant in Latin America for FH and ASCVD patients.There are potentially long-term clinical, humanistic and economic benefits when LDL-C is reduced below target LDL-C goals.