CLINICAL, ECONOMIC, AND HUMANISTIC BURDEN OF ELEVATED LIPOPROTEIN(A) IN PATIENTS WITH ATHEROSCLEROTIC CARDIOVASCULAR DISEASE A SYSTEMATIC LITERATURE REVIEW
Author(s)
Cameron Christian Cook, BA, MA, MS, PhD1, Apurva Pande, MSc2, Kassandra Schaible3, Akvile Chapman, PhD4, Bhanu Inuganti, PhD5, Eduard Sidelnikov, MPH, MSc, PhD, MD6.
1AMGEN, Durham, NC, USA, 2Thermo Fisher Scientific, Boston, MA, USA, 3Thermo Fisher Scientific, Pittsburgh, PA, USA, 4Thermo Fisher Scientific, Newcastle upon Tyne, United Kingdom, 5Thermo Fisher Scientific, Mumbai, India, 6AMGEN (Europe) GmbH, Rotkreuz, Switzerland.
1AMGEN, Durham, NC, USA, 2Thermo Fisher Scientific, Boston, MA, USA, 3Thermo Fisher Scientific, Pittsburgh, PA, USA, 4Thermo Fisher Scientific, Newcastle upon Tyne, United Kingdom, 5Thermo Fisher Scientific, Mumbai, India, 6AMGEN (Europe) GmbH, Rotkreuz, Switzerland.
OBJECTIVES: Elevated lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). This systematic literature review (SLR) synthesized evidence on the clinical, economic, and humanistic burden among adults with ASCVD and elevated Lp(a).
METHODS: The SLR included studies on adults with ASCVD and elevated Lp(a), defined by study-specific thresholds of at least 50 mg/dL or 105 nmol/L, receiving any or no intervention, and reporting clinical, economic, or humanistic outcomes. MEDLINE, Embase, and CENTRAL were searched from January 2010 to October 2025.
RESULTS: Seventy-six unique studies met inclusion criteria and included 8 randomized controlled trials (RCTs), 3 of which were phase 3 trials of PCSK9 or CETP inhibitors, 38 retrospective, 6 ambispective, 23 prospective studies, and 1 pooled analysis. Most studies were from China (n = 21) and the US (n = 14), with a focus on general ASCVD (n = 23). In RCTs, major adverse cardiovascular events (MACE) rates ranged from 5.0% to 17.9%, and were generally lower with active treatment vs placebo, whereas observational studies showed wider variation (6%-40%). Only two studies reported costs, with all-cause costs increasing from $6,706 (overall) to $10,681 for those with Lp(a) >90 mg/dL. Four studies reported healthcare resource utilization (HCRU) outcomes. In the quantitative study, patients with Lp(a) >90 mg/dL had higher inpatient hospitalizations (72.6 vs 64.0 per 100 person-years overall) and practitioner visits (2,996.4 vs 2,856.9 per 100 person-years overall). The only humanistic study in refractory angina with elevated Lp(a) reported that apheresis improved the disease-specific and generic quality-of-life scores vs placebo.
CONCLUSIONS: This SLR demonstrated evidence that elevated Lp(a) is an independent risk factor for ASCVD and is associated with substantially elevated risk of MACE. Available evidence showed that elevated Lp(a) is associated with substantially increased healthcare costs and HCRU; however, economic and humanistic burden evidence remains limited and requires additional research.
METHODS: The SLR included studies on adults with ASCVD and elevated Lp(a), defined by study-specific thresholds of at least 50 mg/dL or 105 nmol/L, receiving any or no intervention, and reporting clinical, economic, or humanistic outcomes. MEDLINE, Embase, and CENTRAL were searched from January 2010 to October 2025.
RESULTS: Seventy-six unique studies met inclusion criteria and included 8 randomized controlled trials (RCTs), 3 of which were phase 3 trials of PCSK9 or CETP inhibitors, 38 retrospective, 6 ambispective, 23 prospective studies, and 1 pooled analysis. Most studies were from China (n = 21) and the US (n = 14), with a focus on general ASCVD (n = 23). In RCTs, major adverse cardiovascular events (MACE) rates ranged from 5.0% to 17.9%, and were generally lower with active treatment vs placebo, whereas observational studies showed wider variation (6%-40%). Only two studies reported costs, with all-cause costs increasing from $6,706 (overall) to $10,681 for those with Lp(a) >90 mg/dL. Four studies reported healthcare resource utilization (HCRU) outcomes. In the quantitative study, patients with Lp(a) >90 mg/dL had higher inpatient hospitalizations (72.6 vs 64.0 per 100 person-years overall) and practitioner visits (2,996.4 vs 2,856.9 per 100 person-years overall). The only humanistic study in refractory angina with elevated Lp(a) reported that apheresis improved the disease-specific and generic quality-of-life scores vs placebo.
CONCLUSIONS: This SLR demonstrated evidence that elevated Lp(a) is an independent risk factor for ASCVD and is associated with substantially elevated risk of MACE. Available evidence showed that elevated Lp(a) is associated with substantially increased healthcare costs and HCRU; however, economic and humanistic burden evidence remains limited and requires additional research.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE296
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas