Okami Suguru, Ohlmeier Christoph, Takeichi Makiko, Aguila Mireia, Holl Katsiaryna, Michel Alexander, Lecomte Coralie, Ide Tomomi
Medical Affairs & Pharmacovigilance, Bayer Yakuhin Ltd., Breeze Tower, 2-4-9 Umeda, Kita-ku, Osaka 530-0001, Japan.
Integrated Evidence Generation & Business Innovation, Bayer AG, 13342 Berlin, Germany.
J Clin Med. 2024 May 30;13(11):3222. doi: 10.3390/jcm13113222.
Vericiguat was developed to treat patients with heart failure (HF). Currently, limited data are available to characterize vericiguat-treated patients in real-world clinical settings. This retrospective cohort study was done using a Japanese hospital administrative database to describe the use of vericiguat in patients with HF in real-world settings. Adult patients diagnosed with HF prescribed vericiguat between 1 July 2021 and 30 September 2022 were included. Patient characteristics at the initiation of vericiguat treatment, patterns of HF medication use, and vericiguat dose titrations were assessed within the first 90 days of treatment. The study included 829 patients who were initiated on vericiguat therapy. The mean age was 75.5 years and 69.0% were male. Hypertension, coronary artery disease, and diabetes mellitus were present in 91.7, 71.3, and 60.1% of patients, respectively. Most patients had previously received HF medications, with high percentages using angiotensin-receptor blocker neprilysin inhibitors (ARNI; 43.9%) and sodium-glucose cotransporter-2 inhibitors (54.4%). During the first 90 days of vericiguat treatment, 65.8% of the patients were uptitrated from their starting dose, and 32.3% had reached the maximal daily dose. The median time to reach the maximal daily dose was 34 days. The multivariable model identified that initiating vericiguat treatment in an outpatient setting and using ARNI before initiating vericiguat treatment were factors significantly associated with reaching the maximal daily dose of vericiguat at any given time, whereas older age, chronic kidney disease, hyperkalemia, and anemia were not associated. These findings provide early insights into the use of vericiguat, which aid in optimizing the combinations and/or sequences of HF treatment incorporating vericiguat therapy.
维立西呱旨在治疗心力衰竭（HF）患者。目前，在真实世界临床环境中，关于维立西呱治疗患者的特征数据有限。这项回顾性队列研究使用日本医院管理数据库来描述维立西呱在真实世界环境中用于HF患者的情况。纳入了2021年7月1日至2022年9月30日期间被诊断为HF并开具维立西呱处方的成年患者。在治疗的前90天内评估了维立西呱治疗开始时的患者特征、HF药物使用模式以及维立西呱剂量滴定情况。该研究纳入了829例开始接受维立西呱治疗的患者。平均年龄为75.5岁，男性占69.0%。高血压、冠状动脉疾病和糖尿病分别存在于91.7%、71.3%和60.1%的患者中。大多数患者之前接受过HF药物治疗，使用血管紧张素受体脑啡肽酶抑制剂（ARNI；43.9%）和钠-葡萄糖协同转运蛋白2抑制剂（54.4%）的比例很高。在维立西呱治疗的前90天内，65.8%的患者从起始剂量上调，32.3%的患者达到了最大日剂量。达到最大日剂量的中位时间为34天。多变量模型确定，在门诊环境中开始维立西呱治疗以及在开始维立西呱治疗前使用ARNI是与在任何给定时间达到维立西呱最大日剂量显著相关的因素，而年龄较大、慢性肾脏病、高钾血症和贫血则无关。这些发现为维立西呱的使用提供了早期见解，有助于优化纳入维立西呱治疗的HF治疗的联合和/或顺序。
