Medication adherence to obeticholic acid: a real-world experience using medication event monitoring systems

OBJECTIVE

We designed a clinical study to analyze patterns of adherence to  obeticholic acid, factors influencing the adherence and potential correlation with  treatment efficacy by using MEMS® cap in practice daily. Method: A multicenter prospective observational study of patients with primary  biliary cholangitis. Adherence will be measured by MEMS® cap, pill count, and  patient-reported outcomes during 3 months. The quality of life will be self- reported using the Chronic Liver Disease Questionnaire test, European Quality of  Life 5-Dimension Questionnaire test and Itch Severity Scale.

CONCLUSIONS

We expect to clarify if there is correlation between adherence with  treatment efficacy and to identify causes for poor compliance and introduce  measures to reduce its prevalence.

Observational multicentre prospective study to assess changes in cognitive function in patients treated with PCSK9i. Study protocol

OBJECTIVE

PCSK9 inhibitors have been shown to reduce LDLc by up to about 60% and 85% when used with high doses of statins and ezetimibe (2019 ESC/EAS Guidelines). These therapies may lead to very low levels of LDLc and have been associated with possible cognitive deterioration. No significant differences were found in the only specific  study (EBBINGHAUS). The objective is to prospectively evaluate cognitive  deterioration and its repercussion on quality of life and changes in LDLc in  patients starting treatment with PCKS9 inhibitors.

METHOD

It is a postauthorization, multicentre, non-randomized, prospective study. Patients starting treatment for the first time with PCSK9 inhibitors will be recruited in 11 Galician Hospitals over a period of 12 months and with 24 months of follow-up. The primary outcome will be to evaluate changes in cognitive function using the Montreal  Cognitive Assessment (MOCA) questionnaire. The secondary outcome will be to evaluate changes in quality of life using the EuroQol-5D. Changes in LDLc will be assessed. The sample size will be 275 patients, taking into account a loss to follow-up of no more than 10%. The primary outcome  will be studied through the dichotomous variable cognitive deterioration (0/1). Cognitive changes over the follow-up period will be analysed using  the McNemar test. In addition, an analytical approach using logistic regression will be followed to identify patients at risk of cognitive deterioration. As a result, this analysis will obtain a frequency measurement: the odds ratio (OR). The specific objectives will be studied  using bivariate analysis. Continuous contrast variables will be studied using the t-test or ANOVA and categorical variables will be studied using the chi- square test.

CONCLUSIONS

The MEMOGAL study will provide information on safety in  terms of cognitive deterioration in patients starting treatment with PCSK9 inhibitors.