Early insights into the characteristics and evolution of clinical parameters in a cohort of patients prescribed sacubitril/valsartan in Germany

• Published in: Postgraduate medicine Vol. 130; no. 3; p. 308
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: England 03.04.2018
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Age Factors; Aged; Aged, 80 and over; Aminobutyrates - administration & dosage; Aminobutyrates - adverse effects; Aminobutyrates - therapeutic use; Angiotensin Receptor Antagonists - administration & dosage; Angiotensin Receptor Antagonists - adverse effects; Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Blood Pressure; Body Mass Index; Comorbidity; Drug Combinations; Electronic Health Records - statistics & numerical data; Female; Germany; Glycated Hemoglobin A - drug effects; Heart Failure - drug therapy; Humans; Male; Middle Aged; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Retrospective Studies; Sex Factors; Tetrazoles - administration & dosage; Tetrazoles - adverse effects; Tetrazoles - therapeutic use; Germany; patient characteristics; PARADIGM-HF; Electronic medical records; heart failure with reduced ejection fraction; sacubitril/valsartan
• ISSN: 1941-9260
• DOI: 10.1080/00325481.2018.1442090

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.