Barriers and Facilitators to the Use of Novel Injectable Lipid-Lowering Therapies in Patients with Dyslipidemia or Cardiovascular Disease: A Scoping Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The reviewed paper addresses the interesting topic of adherence and compliance with physician recommendations by patients receiving modern subcutaneous antilipidemic therapy. The authors address key issues related to drug administration, therapy availability, patient acceptance of the treatment regimen, and organisational challenges. The manuscript's introduction reflects the main directions of the topic, the goal is articulated concisely and clearly, and the methodology is based on generally accepted principles of systematic reviews. The main results section describes the key issues covered in the review. The summary and discussion are concise and explain the presented results. The manuscript includes four tables and one flowchart.

Furthermore, 59 modern publications are cited. The conclusions are well-formulated. Regarding the graphic section, a graphical representation of treatment regimen(s) that include modern drugs for dyslipidemia could be proposed, with a focus on biologics.

Author Response

Dear Peer,

Thank you very much for your effort and time. We hope that in this version, according your precious comments, the manuscript will be suitable for publication.

Thank you again, all Authors

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

This is a well written review of available literature about the psychological barriers and facilitators of the use of novel injectable lipid lowering therapies. ASCVD is the number one cause of mortality and morbidity worldwide. Lipid lowering is well established approach to reduce ASCVD events, however, it remains underutilized. Overcoming barriers and empowering the use of injectable lipid lowering drugs is therefore a very important topic. I support the publication of this review in the journal pending one minor revision.

Major comments - none

Minor comments - I suggest adding in discussion a comparison with available data on the acceptability, barriers and facilitators of injectable drugs used to treat DM and obesity. Inc contrast to PCSK9i, where only measuring of LDL-C response provides a positive feedback, GLP1-RAs have an immediate feedback in terms of weight loss. However, in contrast to PCSK9i, the GLP1-RA class has some unpleasant adverse event profile. Moreover, many providers report that patients already using GLP1-RAs have much less issues with adding a second injectable such as PCSK9i. A discussion of this topic will be valuable. 

Author Response

Dear Peer,

Thank you very much for your effort and time. We hope that in this version, according your precious comments, the manuscript will be suitable for publication.

Thank you again, all Authors

Author Response File: Author Response.docx