Effectiveness and Safety of Anti-PCSK9 Treatment in Persons with Hyperlipidemia: A Register-Based Cohort Study

Abstract Addressing dyslipidaemia, a condition involving abnormal amounts of lipids in the blood, is crucial due to its strong association with cardiovascular disease. Anti-proprotein convertase subtilisin/kexin type 9 (PCSK9) drugs like alirocumab and evolocumab offer promising therapeutic solutions. Here we show, from our register-based cohort study in the Capital Region of Denmark (2016–2022), the efficacy and safety of these drugs in 907 persons with dyslipidaemia. Upon treatment initiation, PCSK9 inhibitors showed a substantial 49% reduction in low-density lipoprotein cholesterol (LDL-C) levels. The mandated switch from alirocumab to evolocumab resulted in no significant difference in LDL-C levels or adverse clinical outcomes, such as major cardiovascular events or mortality. Thus, we conclude both alirocumab and evolocumab can be safely and effectively used interchangeably for treating dyslipidaemia.