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Birmingham and Solihull Integrated Care System’s collaborative approach to injectable lipid-lowering therapy : a patient overview
Abstract
Introduction
Atherosclerotic cardiovascular disease (ASCVD) is the largest contributor to morbidity and mortality worldwide with a global prevalence of 315 million accounting for 9 million deaths per year, half of which are attributable to lifetime exposure to high LDL-c (1). Lowering LDL-c is directly linked directly to reduced ASCVD risk (2). The National Institute for Health and Care Excellence (NICE) Clinical Guideline 238 (CG238) on cardiovascular disease recommends maintaining LDL-c below 2 mmol/L for the secondary prevention of Atherosclerotic Cardiovascular Disease (ASCVD). Patients on a maximal tolerated doses of statin +/- ezetimibe can be considered for injectable lipid-lowering therapies (ILLT) - alirocumab, evolocumab and inclisiran, if they meet the starting criteria specified in Technology Appraisals TA393, TA394 and TA733 respectively.
Method and Results
This study was a collaboration between the Lipid Clinic at Queen Elizabeth Hospital Birmingham (QEHB) and Harborne and Quinton Primary Care Network (HQPCN) to document ASCVD risk factor profiles of all patients currently receiving ILLT for secondary ASCVD prevention. Anonymised data of patients currently on ILLT prescribed by the Lipid Clinic and HQPCN was combined and analysed using MS Excel®.
Currently 318 patients (62% male) at QEHB and HQPCN are on ILLT. 37/ 318 (12%) had familial hypercholesterolaemia, 213/318 (67%) had a history of hypertension, 100/318 (31%) were smokers/ex-smokers, and 92/318 (29%) had type 2 diabetes mellitus. Median BMI was 28.9kg/m2. Pre-ILLT median LDL-c was 3.9 mmol/L, range 2.6 to 7.9 mmol/L. 47/318 (15%) patients had high LDL-c as their only ASCVD risk factor. 109/318 (34%) were between the ages of 60 and 70 when they started treatment with ILLT, 69/109 (63%) were males.
Summary and Conclusion
Patients currently being treated with ILLT at QEHB and HQOHP for secondary prevention of ASCVD are predominantly male aged between 60 and 70 years with mean pre-treatment LDL-c 3.9 mmol/L and BMI 28.9kg/m2. The commonest additional risk factor was hypertension (67%) followed by smoking (31%) and type 2 diabetes mellitus (29%). 12% patients have familial hypercholesterolaemia. Only 15% had high LDL-c cholesterol as their only ASCVD risk factor. This highlights the importance of managing multiple comorbidities alongside the cholesterol in the ongoing care of patients with ASCVD.
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Date
2025-07-10
Type
Conference Output
Subject
Cardiovascular Diseases
Collections
Citation
Ochoa-Ferraro, A., Joall, S., Huckerby, C., Johal, J. and Charlotte Dawson (2025) 'Birmingham and Solihull Integrated Care System’s collaborative approach to injectable lipid-lowering therapy : a patient overview'. Heart UK Conference. University of Warwick, Coventry; 7-10 July.
Journal / Source Title
DOI
PMID
Publisher
University Hospitals Birmingham NHS Foundation Trust