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Retrospective real-world analysis of adherence and persistence to lipid-lowering therapy in Germany.
- Source :
-
Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Jun; Vol. 113 (6), pp. 812-821. Date of Electronic Publication: 2023 Aug 21. - Publication Year :
- 2024
-
Abstract
- Background: Cardiovascular disease is the leading cause of mortality in Germany. Cardiovascular risk can be mitigated with long-term lipid-lowering therapies (LLTs) that reduce levels of low-density lipoprotein cholesterol. Although effective, risk mitigation is hindered by poor persistence and adherence.<br />Objective: To investigate real-world persistence and adherence to LLTs through 36 months post-initiation.<br />Methods: This retrospective cohort study included patients with dyslipidemia who were newly prescribed LLTs between July and December 2017, using anonymized prescription data from the Insight Health™ Patient Insight Tool, and followed up until March 2021. Persistence and adherence to the therapies were stratified by age and sex. The proportion of days covered (PDC) was used to measure adherence.<br />Results: Patients with dyslipidemia and newly prescribed statins (n = 865,732), ezetimibe (n = 34,490), or anti-proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (anti-PCSK9 mAbs; n = 1940) were included. Persistence to LLTs declined gradually across all treatment subgroups and was lower in women than men. Adherence, calculated as the mean PDC at the end of the analysis period (July 2017‒March 2021) was 0.84, 0.92, and 0.93 for statins, ezetimibe, and anti-PCSK9 mAbs, respectively. Among patients who discontinued treatment, mean treatment duration was 265, 255, and 387 days for statins, ezetimibe, and anti-PCSK9 mAbs, respectively. Only ~ 10% of patients persisted between 201 and 300 days. By Day 300, 71% of patients on statins had discontinued treatment. At 36 months, overall persistence rates were lowest with statins (20.6%), followed by ezetimibe (22.3%) and anti-PCSK9 mAbs (50.9%).<br />Conclusions: High non-persistence rates were observed across all LLT regimens analyzed, with the lowest persistence rates observed with statins.<br /> (© 2023. The Author(s).)
- Subjects :
- Humans
Male
Female
Retrospective Studies
Germany epidemiology
Middle Aged
Aged
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Cholesterol, LDL blood
Ezetimibe therapeutic use
Anticholesteremic Agents therapeutic use
Cardiovascular Diseases epidemiology
Cardiovascular Diseases drug therapy
PCSK9 Inhibitors
Time Factors
Follow-Up Studies
Medication Adherence statistics & numerical data
Dyslipidemias drug therapy
Dyslipidemias epidemiology
Dyslipidemias blood
Subjects
Details
- Language :
- English
- ISSN :
- 1861-0692
- Volume :
- 113
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Publication Type :
- Academic Journal
- Accession number :
- 37603070
- Full Text :
- https://doi.org/10.1007/s00392-023-02257-6