Real‐world treatment patterns of sacubitril/valsartan: a longitudinal cohort study in Germany
| Autor: | A.F Fonseca, Karel Kostev, Raymond G. Schlienger, Elisabeth Kap, J. Engelhard, Rolf Wachter, Sara Bruce Wirta, B. Balas, Sven Klebs |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Databases Factual Epidemiology medicine.medical_treatment Tetrazoles Angiotensin receptor-neprilysin inhibitor Compliance Dose titration Heart failure Persistence 030204 cardiovascular system & hematology Sacubitril Persistence (computer science) Cohort Studies 0302 clinical medicine Cardiologists Germany Longitudinal Studies Practice Patterns Physicians' Diuretics Research Articles Angiotensin receptor–neprilysin inhibitor Aged 80 and over Aminobutyrates Middle Aged 3. Good health Drug Combinations Valsartan Female Neprilysin Cardiology and Cardiovascular Medicine medicine.drug Research Article medicine.medical_specialty Medication Adherence 03 medical and health sciences Angiotensin Receptor Antagonists General Practitioners Internal medicine medicine Humans Aged Retrospective Studies business.industry Biphenyl Compounds Retrospective cohort study medicine.disease Concomitant Diuretic business Sacubitril Valsartan |
| Zdroj: | European Journal of Heart Failure |
| Popis: | AIMS: To analyse real-world treatment patterns of sacubitril/valsartan (sac/val) using data from a pharmacy database in Germany. METHODS AND RESULTS: A retrospective cohort study of 26 191 adult patients (aged ≥ 18 years) in the IMS® longitudinal prescriptions database in Germany who were dispensed sac/val from January 2016 to June 2017 was conducted. The analysis included sac/val dose titration assessed in the 6 months from first sac/val prescription; prescriptions of concomitant cardiovascular medications in the 6 months pre- and post-index and compliance and persistence during 12 months post-index. Two-thirds of patients were prescribed the lowest sac/val dose of 50 mg twice daily (b.i.d.) at index and up-titration during the first 6 months was attempted in 41% of these patients. Ten percent of patients prescribed 200 mg b.i.d. at index had to be stably down-titrated; among patients prescribed 50 or 100 mg b.i.d. at index that were up-titrated, > 80% remained on the higher dose. Overall, the mean daily diuretic dose decreased by 25% after initiation of sac/val. High compliance and persistence rates were observed across sac/val doses, increasing with higher sac/val dose at index. Prior dose of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker had only minor impact on first sac/val dose, compliance and persistence. CONCLUSIONS: Most patients prescribed sac/val are not initiated on the recommended dose nor up-titrated as recommended by the EU Summary of Product Characteristics. Initiation of sac/val was associated with high persistence and compliance and a dose reduction of diuretics. Barriers to up-titration must be explored. peerReviewed |
| Databáze: | OpenAIRE |
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