Wachter Rolf, Viriato Daniel, Klebs Sven, Grunow Stefanie S, Schindler Matthias, Engelhard Johanna, Proenca Catia C, Calado Frederico, Schlienger Raymond, Dworak Markus, Balas Bogdan, Bruce Wirta Sara
a Clinic and Policlinic for Cardiology , University Hospital Leipzig , Leipzig , Germany.
b Global Health Economics and Outcomes Research , Novartis Pharma AG , Basel , Switzerland.
Postgrad Med. 2018 Apr;130(3):308-316. doi: 10.1080/00325481.2018.1442090. Epub 2018 Feb 28.
This study aimed to provide early insights into sacubitril/valsartan (sac/val) prescription patterns and the demographic and clinical characteristics of patients prescribed sac/val in primary care and cardiology settings in Germany.
The study used electronic medical records from the German IMS® Disease Analyzer database. Patients with ≥1 prescription for sac/val during 1 January-31 December 2016 (n = 1643) were identified and followed up for ≤12 months from first prescription. Patients with ≥1 heart failure (HF) diagnosis during the study period, ≥1 additional HF diagnosis in the full history of the database, and ≥1 prescription for an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and a β-blocker during the study period, without a prescription for sac/val (n = 25,264), were included as a reference cohort. Changes in clinical parameters in the 12 months before and after sac/val initiation were investigated and compared with those from the PARADIGM-HF study.
The characteristics of patients prescribed sac/val more closely resembled those of patients enrolled in PARADIGM-HF (e.g. younger age, higher proportion of men than women, lower systolic blood pressure) than patients in the reference cohort. Most patients were initiated on the lowest dose of sac/val irrespective of clinical setting. Significant decreases (p < 0.001) in NT-proBNP and glycated haemoglobin levels were observed following sac/val initiation.
Patients prescribed sac/val had similar baseline demographics and clinical characteristics to those from PARADIGM-HF, and most patients were initiated on the lowest dose. Changes in clinical parameters before and after initiation mirrored findings from the PARADIGM-HF study.
本研究旨在对沙库巴曲缬沙坦(沙库/缬)的处方模式以及在德国初级医疗和心脏病学环境中开具沙库/缬处方的患者的人口统计学和临床特征进行早期洞察。
本研究使用了来自德国IMS®疾病分析数据库的电子病历。确定了在2016年1月1日至12月31日期间有≥1次沙库/缬处方的患者(n = 1643),并从首次处方开始随访≤12个月。将在研究期间有≥1次心力衰竭(HF)诊断、在数据库完整病史中有≥1次额外HF诊断以及在研究期间有≥1次血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂和β受体阻滞剂处方但无沙库/缬处方的患者(n = 25,264)纳入作为参考队列。研究了沙库/缬起始前后12个月内临床参数的变化,并与PARADIGM-HF研究的结果进行了比较。
与参考队列中的患者相比,开具沙库/缬处方的患者的特征与PARADIGM-HF研究中纳入的患者更相似(例如,年龄较小、男性比例高于女性、收缩压较低)。无论临床环境如何,大多数患者开始使用最低剂量的沙库/缬。沙库/缬起始后,NT-proBNP和糖化血红蛋白水平显著降低(p < 0.001)。
开具沙库/缬处方的患者的基线人口统计学和临床特征与PARADIGM-HF研究中的患者相似,且大多数患者开始使用最低剂量。起始前后临床参数的变化反映了PARADIGM-HF研究的结果。