Abstract
OBJECTIVES: To estimate the burden of CVD and the impact of LDL-C lowering in patients with FH or ASCVD with uncontrolled LDL-C levels in Saudi Arabia (SA) and United Arab Emirates (UAE). METHODS: The number of statin-treated national patients with FH or ASCVD with uncontrolled LDL-C>100mg/dL (>2.6 mmol/L) in SA and UAE was estimated based on country population and 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 Treatment Trialists' Collaboration, a large meta-analysis of statin 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 national patients with FH or ASCVD with uncontrolled LDL-C was estimated at 28,692 FH and 293,697 ASCVD in SA; 2,419 FH and 27,606 ASCVD in UAE. 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, a decrease in hospitalization costs of $5,225 USD in SA and $5,008 USD in UAE, and an average increase of 3.26 QALY. Similarly, over the lifetime of an individual with ASCVD, the additional LDL-C lowering with evolocumab was projected to result in a 0.44 (23%) CVD event reduction, a decrease in hospitalization costs of $4,403 USD in SA and $4,219 USD in UAE, and an average increase of 1.84 QALY. CONCLUSIONS: CVD burden is significant in SA and UAE for FH and ASCVD patients. There is a great potential for clinical and economic benefits with further LDL-C reduction using evolocumab on top of statin therapy.