Simvastatin prescribing patterns before and after FDA dosing restrictions: a retrospective analysis of a large healthcare claims database
Autor: | Joseph J. Saseen, Kavita V. Nair, Rhianna M. Tuchscherer, Vahram Ghushchyan |
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Rok vydání: | 2014 |
Předmět: |
Male
medicine.medical_specialty Simvastatin Comorbidity Off-label use Drug Prescriptions Patient safety Pharmacovigilance Muscular Diseases Risk Factors polycyclic compounds Medicine Humans Pharmacology (medical) Drug Interactions cardiovascular diseases Amlodipine Dosing Practice Patterns Physicians' Adverse effect Drug Labeling Dyslipidemias Retrospective Studies Insurance Health business.industry United States Food and Drug Administration Incidence nutritional and metabolic diseases Retrospective cohort study General Medicine Off-Label Use Middle Aged Calcium Channel Blockers United States Emergency medicine Hypertension lipids (amino acids peptides and proteins) Female Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business medicine.drug |
Zdroj: | American journal of cardiovascular drugs : drugs, devices, and other interventions. 15(1) |
ISSN: | 1179-187X |
Popis: | Muscle-related events, or myopathies, are a commonly reported adverse event associated with statin use. In June 2011, the US FDA released a Drug Safety Communication that provided updated product labeling with dosing restrictions for simvastatin to minimize the risk of myopathies. Our objective was to describe prescribing patterns of simvastatin in combination with medications known to increase the risk of myopathies following updated product labeling dosing restrictions in June 2011. A retrospective observational analysis was carried out, in which administrative claims data were utilized to identify prescribing patterns of simvastatin in combination with calcium channel blockers (CCBs) and other pre-specified drug therapies. Prescribing patterns were analyzed on a monthly basis 24 months prior to and 9 months following product label changes. Incidence of muscle-related events was also analyzed. In June 2011, a total of 60 % of patients with overlapping simvastatin–CCB claims and 94 % of patients with overlapping simvastatin–non-CCB claims were prescribed an against-label combination. As of March 2012, a total of 41 % and 93 % of patients continued to be prescribed against-label simvastatin–CCB and simvastatin–non-CCB combinations, respectively. The most commonly prescribed dose of simvastatin was 20 mg (39 %). Against-label combinations were most commonly prescribed at a simvastatin dose of 40 mg (56 %). Amlodipine was the most commonly prescribed CCB in combination with simvastatin (70 %) and the most common CCB prescribed against-label (67 %). Despite improvements in prescribing practices, many patients are still exposed to potentially harmful simvastatin combinations. Aggressive changes in simvastatin prescribing systems and processes are needed to improve compliance with FDA labeling to improve medication and patient safety. |
Databáze: | OpenAIRE |
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