Sex Differences in the Treatment With PCSK9 Monoclonal Antibodies- Real World Experience From a Dedicated Preventive Cardiology Clinic

Authors

• Lital Hodeda
• Alon Eisen
• Aviad Rotholz
• Ran Kornowski
• Chen Gurevitz

Language

English

Publication Date

9-1-2025

Journal

American Journal of Preventive Cardiology

DOI

10.1016/j.ajpc.2025.101022

PMID

40677276

PMCID

PMC12269634

PubMedCentral® Posted Date

6-22-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Purpose: Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9 mAb) lower low-density lipoprotein cholesterol (LDL-C) levels and reduce atherosclerotic cardiovascular disease (ASCVD). Data regarding sex differences in PCSK9 mAb treatment remain lacking. This study examines sex differences in patients' characteristics, indications, efficacy, and safety of PCSK9 mAb treatment.

Methods: Retrospective study based on data from the Preventive Cardiology and Lipids Clinic in Rabin Medical Center on patients prescribed with PCSK9 mAb. Collected data included medical background, medications, indications and laboratory data, analyzed by sex.

Results: 246 patients were included (mean age 67y, ASCVD 78.8 %, mean baseline LDL-C 128.2 mg/dL). Women (42 %) prescribed with PCSK9 mAb were older (69y vs. 65y, respectively; p < 0.001) and had higher baseline LDL-C (138.9 vs. 117.3 mg/dL; p < 0.001) than men. The dominant indication for PCSK9 mAb therapy in both sexes was secondary prevention, however, primary prevention was more prevalent in women (39.4 % vs. 16.3 %, respectively; p < 0.001). Overall, high adherence to treatment was observed without sex differences (91.8 % and 79.7 % at 3 and 12 months, respectively). After 1-year, adherent women had higher LDL-C levels than adherent men (61.9 vs. 46.8 mg/dL, respectively; P = 0.001), and were less likely to reach their LDL-C goals; >70 mg/dL (62.2 % vs. 76.1 %, respectively; P = 0.032) and > 55 mg/dL (39.8 % vs. 60.1 % respectively; P = 0.003).

Conclusions: PCSK9 mAbs treatment demonstrated sex differences in prescription age, indications, baseline LDL-C and achievement of LDL-C goals. Adherence to PCSK9 mAb therapy was higher than previously reported, possibly due to careful surveillance strategy in a dedicated prevention clinic.

Keywords

Atherosclerotic cardiovascular disease (ASCVD), Low-density lipoprotein cholesterol (LDL-C), PCSK9 mAb, Sex differences

Published Open-Access

yes

Recommended Citation

Hodeda, Lital; Eisen, Alon; Rotholz, Aviad; et al., "Sex Differences in the Treatment With PCSK9 Monoclonal Antibodies- Real World Experience From a Dedicated Preventive Cardiology Clinic" (2025). Faculty, Staff and Student Publications. 976.
https://digitalcommons.library.tmc.edu/uthshis_docs/976