Department of Drug Statistics, Norwegian Institute of Public Health, 0213 Oslo, Norway.
Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, 0213 Oslo, Norway.
Int J Environ Res Public Health. 2022 Jan 26;19(3):1370. doi: 10.3390/ijerph19031370.
Kidney transplant recipients (KTRs) experience increased risk of cardiovascular disease. Guidelines recommend HMG-CoA reductase inhibitor (statin) therapy when tolerated. We aimed to study changes in the prescription of statins and patients' adherence to treatment over time. A population-based observational study utilizing linked data from the Norwegian Renal Registry (national coverage of 99.9%) and the Norwegian Prescription Database was performed. Data from a total of 2250 first KTRs were included (mean age-54 years, 69% men). Dispensed prescriptions of statins and immunosuppressants for the period 2004-2016 for all first KTRs engrafted in the period 2005-2015 were analyzed. Seventy-two percent received statins the first year after kidney transplantation and the proportion increased with age. The proportion receiving a statin varied according to the time frame of transplantation (77% in 2005-2010 vs. 66% in 2012-2015). Among new users of statins, 82% of the patients were adherent both the second and third year after kidney transplantation, while the corresponding figure for those already receiving statins before transplantation was 97%. Statin continuation rates in KTRs were high. In conclusion, our findings show a slightly lower overall proportion of patients receiving statins after kidney transplants than the national target level of 80%. The proportion of statin users increased with the age of the KTRs but showed a decreasing trend as time progressed.
肾移植受者(KTR)患心血管疾病的风险增加。指南建议在耐受的情况下使用 HMG-CoA 还原酶抑制剂(他汀类药物)治疗。我们旨在研究随着时间的推移,他汀类药物的处方和患者治疗的依从性的变化。本研究是一项基于人群的观察性研究,利用来自挪威肾脏登记处(全国覆盖率 99.9%)和挪威处方数据库的相关数据进行。共纳入了 2250 例首次肾移植患者(平均年龄 54 岁,69%为男性)。分析了所有首次肾移植患者在 2005-2015 年期间接受的他汀类药物和免疫抑制剂的处方。72%的患者在肾移植后第一年接受他汀类药物治疗,且该比例随年龄增加而增加。接受他汀类药物治疗的比例因移植时间框架而异(2005-2010 年为 77%,2012-2015 年为 66%)。在新使用他汀类药物的患者中,82%的患者在肾移植后第二年和第三年仍保持用药依从性,而在移植前已开始使用他汀类药物的患者中,这一比例为 97%。肾移植受者中他汀类药物的持续使用率较高。总之,我们的研究结果显示,肾移植后接受他汀类药物治疗的患者比例略低于全国 80%的目标水平。随着 KTR 年龄的增长,使用他汀类药物的比例增加,但随着时间的推移呈下降趋势。