Patient Characteristics and Real-World Treatment Patterns Among Early Users of PCSK9 Inhibitors
Background Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) reduce low-density lipoprotein cholesterol (LDL-C) levels and are approved for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease who require additional LDL-C lowering. Objective Our objec...
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| Veröffentlicht in: | American journal of cardiovascular drugs : drugs, devices, and other interventions devices, and other interventions, 2018-04, Vol.18 (2), p.103-108 |
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| creator | Rane, Pallavi B. Patel, Jeetvan Harrison, David J. Shepherd, Jason Leith, Andrea Bailey, Hollie Piercy, James |
| description | Background
Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) reduce low-density lipoprotein cholesterol (LDL-C) levels and are approved for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease who require additional LDL-C lowering.
Objective
Our objective was to characterize patients receiving PCSK9i medications in real-world practice and describe physician-reported treatment patterns among dyslipidemia patients using PCSK9i or other lipid-lowering therapy.
Methods
We analyzed data from a point-in-time Adelphi dyslipidemia disease-specific programme (DSP) survey conducted in the USA in 2016. Physicians provided treatment history, laboratory values, patient characteristics, and comorbidities for treated patients. To ensure sufficient numbers of PCSK9i-treated patients, we conducted systematic oversampling of patients being prescribed PCSK9i. Outcomes included patient characteristics and physician-reported treatment patterns.
Results
The DSP included 159 physicians, who provided information on 1522 patients (304 PCSK9i; 1218 non-PCSK9i). Mean ± standard deviation (SD) baseline LDL-C levels were 180.0 ± 39.7 mg/dl for PCSK9i patients and 159.2 ± 40.5 mg/dl for non-PCSK9i patients. Prior statin use was reported in 69.1% of PCSK9i patients and 19.5% of non-PCSK9i patients, and physician-reported statin intolerance was observed in 31.6% of PCSK9i and 5.3% of non-PCSK9i patients. Use of statins only was reported in 40.5% of PCSK9i and 88.8% of non-PCSK9i patients. The most common physician-reported reasons for change to PCSK9i were lack of efficacy (70.2%) and muscle-related symptoms (myalgia 28.6%; myopathy 11.1%).
Conclusions
Physicians surveyed appeared to prescribe PCSK9i medications appropriately. PCSK9i-treated patients had higher rates of cardiovascular comorbidities and physician-determined statin intolerance, had higher LDL-C levels, and received more lines of therapy than non-PCSK9i patients. |
| doi_str_mv | 10.1007/s40256-017-0246-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2149615240</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2149615240</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-4879367df8cefb8a118c3338d69706028932d320f8341af8e4f4989ddf1c16c63</originalsourceid><addsrcrecordid>eNp1kE1PAjEURRujEUR_gBvTxHW1X0zbJSGoRBKJQnTXlJkWhswHtsMCfr3FQV25ek3eufc1B4Brgu8IxuI-cEz7CcJEIEx5gvYnoEuIUIhI8XH6_e4jRoXogIsQ1jiCVKhz0KFScsUS3AV6aprcVg0crow3aWN9Hpo8DdBUGXy1pkDvtS8yOPPWNOUBjIFIVQEOyrpawpHxxQ7Og_UB1g5Oh2_PCo6rVb7Im9qHS3DmTBHs1XH2wPxhNBs-ocnL43g4mKCUCdogLkX8j8icTK1bSEOITBljMkuUwAmmUjGaMYqdZJwYJy13XEmVZY6kJEkT1gO3be_G159bGxq9rre-iic1JVwlpE85jhRpqdTXIXjr9MbnpfE7TbA-KNWtUh1N6YNSvY-Zm2PzdlHa7Dfx4zACtAVCXFVL6_9O_9_6BRwogO4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2149615240</pqid></control><display><type>article</type><title>Patient Characteristics and Real-World Treatment Patterns Among Early Users of PCSK9 Inhibitors</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Rane, Pallavi B. ; Patel, Jeetvan ; Harrison, David J. ; Shepherd, Jason ; Leith, Andrea ; Bailey, Hollie ; Piercy, James</creator><creatorcontrib>Rane, Pallavi B. ; Patel, Jeetvan ; Harrison, David J. ; Shepherd, Jason ; Leith, Andrea ; Bailey, Hollie ; Piercy, James</creatorcontrib><description>Background
Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) reduce low-density lipoprotein cholesterol (LDL-C) levels and are approved for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease who require additional LDL-C lowering.
Objective
Our objective was to characterize patients receiving PCSK9i medications in real-world practice and describe physician-reported treatment patterns among dyslipidemia patients using PCSK9i or other lipid-lowering therapy.
Methods
We analyzed data from a point-in-time Adelphi dyslipidemia disease-specific programme (DSP) survey conducted in the USA in 2016. Physicians provided treatment history, laboratory values, patient characteristics, and comorbidities for treated patients. To ensure sufficient numbers of PCSK9i-treated patients, we conducted systematic oversampling of patients being prescribed PCSK9i. Outcomes included patient characteristics and physician-reported treatment patterns.
Results
The DSP included 159 physicians, who provided information on 1522 patients (304 PCSK9i; 1218 non-PCSK9i). Mean ± standard deviation (SD) baseline LDL-C levels were 180.0 ± 39.7 mg/dl for PCSK9i patients and 159.2 ± 40.5 mg/dl for non-PCSK9i patients. Prior statin use was reported in 69.1% of PCSK9i patients and 19.5% of non-PCSK9i patients, and physician-reported statin intolerance was observed in 31.6% of PCSK9i and 5.3% of non-PCSK9i patients. Use of statins only was reported in 40.5% of PCSK9i and 88.8% of non-PCSK9i patients. The most common physician-reported reasons for change to PCSK9i were lack of efficacy (70.2%) and muscle-related symptoms (myalgia 28.6%; myopathy 11.1%).
Conclusions
Physicians surveyed appeared to prescribe PCSK9i medications appropriately. PCSK9i-treated patients had higher rates of cardiovascular comorbidities and physician-determined statin intolerance, had higher LDL-C levels, and received more lines of therapy than non-PCSK9i patients.</description><identifier>ISSN: 1175-3277</identifier><identifier>EISSN: 1179-187X</identifier><identifier>DOI: 10.1007/s40256-017-0246-z</identifier><identifier>PMID: 28849360</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Anticholesteremic Agents - therapeutic use ; Atherosclerosis - drug therapy ; Atherosclerosis - metabolism ; Cardiology ; Cardiovascular disease ; Cholesterol ; Cholesterol, LDL ; Dyslipidemias - drug therapy ; Dyslipidemias - metabolism ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hyperlipoproteinemia Type II - drug therapy ; Hyperlipoproteinemia Type II - metabolism ; Hypolipidemic Agents - therapeutic use ; Lipids ; Lipoproteins ; Male ; Medicine ; Medicine & Public Health ; Metabolic disorders ; Middle Aged ; Original Research Article ; Patients ; Pharmacology/Toxicology ; Pharmacotherapy ; Physicians ; Proprotein Convertase 9 - antagonists & inhibitors ; Statins ; Studies</subject><ispartof>American journal of cardiovascular drugs : drugs, devices, and other interventions, 2018-04, Vol.18 (2), p.103-108</ispartof><rights>Springer International Publishing AG 2017</rights><rights>Copyright Springer Science & Business Media Apr 2018</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-4879367df8cefb8a118c3338d69706028932d320f8341af8e4f4989ddf1c16c63</citedby><cites>FETCH-LOGICAL-c372t-4879367df8cefb8a118c3338d69706028932d320f8341af8e4f4989ddf1c16c63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40256-017-0246-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40256-017-0246-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28849360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rane, Pallavi B.</creatorcontrib><creatorcontrib>Patel, Jeetvan</creatorcontrib><creatorcontrib>Harrison, David J.</creatorcontrib><creatorcontrib>Shepherd, Jason</creatorcontrib><creatorcontrib>Leith, Andrea</creatorcontrib><creatorcontrib>Bailey, Hollie</creatorcontrib><creatorcontrib>Piercy, James</creatorcontrib><title>Patient Characteristics and Real-World Treatment Patterns Among Early Users of PCSK9 Inhibitors</title><title>American journal of cardiovascular drugs : drugs, devices, and other interventions</title><addtitle>Am J Cardiovasc Drugs</addtitle><addtitle>Am J Cardiovasc Drugs</addtitle><description>Background
Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) reduce low-density lipoprotein cholesterol (LDL-C) levels and are approved for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease who require additional LDL-C lowering.
Objective
Our objective was to characterize patients receiving PCSK9i medications in real-world practice and describe physician-reported treatment patterns among dyslipidemia patients using PCSK9i or other lipid-lowering therapy.
Methods
We analyzed data from a point-in-time Adelphi dyslipidemia disease-specific programme (DSP) survey conducted in the USA in 2016. Physicians provided treatment history, laboratory values, patient characteristics, and comorbidities for treated patients. To ensure sufficient numbers of PCSK9i-treated patients, we conducted systematic oversampling of patients being prescribed PCSK9i. Outcomes included patient characteristics and physician-reported treatment patterns.
Results
The DSP included 159 physicians, who provided information on 1522 patients (304 PCSK9i; 1218 non-PCSK9i). Mean ± standard deviation (SD) baseline LDL-C levels were 180.0 ± 39.7 mg/dl for PCSK9i patients and 159.2 ± 40.5 mg/dl for non-PCSK9i patients. Prior statin use was reported in 69.1% of PCSK9i patients and 19.5% of non-PCSK9i patients, and physician-reported statin intolerance was observed in 31.6% of PCSK9i and 5.3% of non-PCSK9i patients. Use of statins only was reported in 40.5% of PCSK9i and 88.8% of non-PCSK9i patients. The most common physician-reported reasons for change to PCSK9i were lack of efficacy (70.2%) and muscle-related symptoms (myalgia 28.6%; myopathy 11.1%).
Conclusions
Physicians surveyed appeared to prescribe PCSK9i medications appropriately. PCSK9i-treated patients had higher rates of cardiovascular comorbidities and physician-determined statin intolerance, had higher LDL-C levels, and received more lines of therapy than non-PCSK9i patients.</description><subject>Anticholesteremic Agents - therapeutic use</subject><subject>Atherosclerosis - drug therapy</subject><subject>Atherosclerosis - metabolism</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Cholesterol, LDL</subject><subject>Dyslipidemias - drug therapy</subject><subject>Dyslipidemias - metabolism</subject><subject>Female</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Hyperlipoproteinemia Type II - drug therapy</subject><subject>Hyperlipoproteinemia Type II - metabolism</subject><subject>Hypolipidemic Agents - therapeutic use</subject><subject>Lipids</subject><subject>Lipoproteins</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic disorders</subject><subject>Middle Aged</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacotherapy</subject><subject>Physicians</subject><subject>Proprotein Convertase 9 - antagonists & inhibitors</subject><subject>Statins</subject><subject>Studies</subject><issn>1175-3277</issn><issn>1179-187X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1PAjEURRujEUR_gBvTxHW1X0zbJSGoRBKJQnTXlJkWhswHtsMCfr3FQV25ek3eufc1B4Brgu8IxuI-cEz7CcJEIEx5gvYnoEuIUIhI8XH6_e4jRoXogIsQ1jiCVKhz0KFScsUS3AV6aprcVg0crow3aWN9Hpo8DdBUGXy1pkDvtS8yOPPWNOUBjIFIVQEOyrpawpHxxQ7Og_UB1g5Oh2_PCo6rVb7Im9qHS3DmTBHs1XH2wPxhNBs-ocnL43g4mKCUCdogLkX8j8icTK1bSEOITBljMkuUwAmmUjGaMYqdZJwYJy13XEmVZY6kJEkT1gO3be_G159bGxq9rre-iic1JVwlpE85jhRpqdTXIXjr9MbnpfE7TbA-KNWtUh1N6YNSvY-Zm2PzdlHa7Dfx4zACtAVCXFVL6_9O_9_6BRwogO4</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Rane, Pallavi B.</creator><creator>Patel, Jeetvan</creator><creator>Harrison, David J.</creator><creator>Shepherd, Jason</creator><creator>Leith, Andrea</creator><creator>Bailey, Hollie</creator><creator>Piercy, James</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20180401</creationdate><title>Patient Characteristics and Real-World Treatment Patterns Among Early Users of PCSK9 Inhibitors</title><author>Rane, Pallavi B. ; Patel, Jeetvan ; Harrison, David J. ; Shepherd, Jason ; Leith, Andrea ; Bailey, Hollie ; Piercy, James</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-4879367df8cefb8a118c3338d69706028932d320f8341af8e4f4989ddf1c16c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anticholesteremic Agents - therapeutic use</topic><topic>Atherosclerosis - drug therapy</topic><topic>Atherosclerosis - metabolism</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Cholesterol, LDL</topic><topic>Dyslipidemias - drug therapy</topic><topic>Dyslipidemias - metabolism</topic><topic>Female</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Hyperlipoproteinemia Type II - drug therapy</topic><topic>Hyperlipoproteinemia Type II - metabolism</topic><topic>Hypolipidemic Agents - therapeutic use</topic><topic>Lipids</topic><topic>Lipoproteins</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic disorders</topic><topic>Middle Aged</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacotherapy</topic><topic>Physicians</topic><topic>Proprotein Convertase 9 - antagonists & inhibitors</topic><topic>Statins</topic><topic>Studies</topic><toplevel>online_resources</toplevel><creatorcontrib>Rane, Pallavi B.</creatorcontrib><creatorcontrib>Patel, Jeetvan</creatorcontrib><creatorcontrib>Harrison, David J.</creatorcontrib><creatorcontrib>Shepherd, Jason</creatorcontrib><creatorcontrib>Leith, Andrea</creatorcontrib><creatorcontrib>Bailey, Hollie</creatorcontrib><creatorcontrib>Piercy, James</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>American journal of cardiovascular drugs : drugs, devices, and other interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rane, Pallavi B.</au><au>Patel, Jeetvan</au><au>Harrison, David J.</au><au>Shepherd, Jason</au><au>Leith, Andrea</au><au>Bailey, Hollie</au><au>Piercy, James</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient Characteristics and Real-World Treatment Patterns Among Early Users of PCSK9 Inhibitors</atitle><jtitle>American journal of cardiovascular drugs : drugs, devices, and other interventions</jtitle><stitle>Am J Cardiovasc Drugs</stitle><addtitle>Am J Cardiovasc Drugs</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>18</volume><issue>2</issue><spage>103</spage><epage>108</epage><pages>103-108</pages><issn>1175-3277</issn><eissn>1179-187X</eissn><abstract>Background
Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) reduce low-density lipoprotein cholesterol (LDL-C) levels and are approved for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease who require additional LDL-C lowering.
Objective
Our objective was to characterize patients receiving PCSK9i medications in real-world practice and describe physician-reported treatment patterns among dyslipidemia patients using PCSK9i or other lipid-lowering therapy.
Methods
We analyzed data from a point-in-time Adelphi dyslipidemia disease-specific programme (DSP) survey conducted in the USA in 2016. Physicians provided treatment history, laboratory values, patient characteristics, and comorbidities for treated patients. To ensure sufficient numbers of PCSK9i-treated patients, we conducted systematic oversampling of patients being prescribed PCSK9i. Outcomes included patient characteristics and physician-reported treatment patterns.
Results
The DSP included 159 physicians, who provided information on 1522 patients (304 PCSK9i; 1218 non-PCSK9i). Mean ± standard deviation (SD) baseline LDL-C levels were 180.0 ± 39.7 mg/dl for PCSK9i patients and 159.2 ± 40.5 mg/dl for non-PCSK9i patients. Prior statin use was reported in 69.1% of PCSK9i patients and 19.5% of non-PCSK9i patients, and physician-reported statin intolerance was observed in 31.6% of PCSK9i and 5.3% of non-PCSK9i patients. Use of statins only was reported in 40.5% of PCSK9i and 88.8% of non-PCSK9i patients. The most common physician-reported reasons for change to PCSK9i were lack of efficacy (70.2%) and muscle-related symptoms (myalgia 28.6%; myopathy 11.1%).
Conclusions
Physicians surveyed appeared to prescribe PCSK9i medications appropriately. PCSK9i-treated patients had higher rates of cardiovascular comorbidities and physician-determined statin intolerance, had higher LDL-C levels, and received more lines of therapy than non-PCSK9i patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28849360</pmid><doi>10.1007/s40256-017-0246-z</doi><tpages>6</tpages></addata></record> |
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| subjects | Anticholesteremic Agents - therapeutic use Atherosclerosis - drug therapy Atherosclerosis - metabolism Cardiology Cardiovascular disease Cholesterol Cholesterol, LDL Dyslipidemias - drug therapy Dyslipidemias - metabolism Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Hyperlipoproteinemia Type II - drug therapy Hyperlipoproteinemia Type II - metabolism Hypolipidemic Agents - therapeutic use Lipids Lipoproteins Male Medicine Medicine & Public Health Metabolic disorders Middle Aged Original Research Article Patients Pharmacology/Toxicology Pharmacotherapy Physicians Proprotein Convertase 9 - antagonists & inhibitors Statins Studies |
| title | Patient Characteristics and Real-World Treatment Patterns Among Early Users of PCSK9 Inhibitors |
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