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

Postgrad Med. 2018 Apr;130(3):308-316. doi: 10.1080/00325481.2018.1442090. Epub 2018 Feb 28.

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Electronic medical records; PARADIGM-HF; heart failure with reduced ejection fraction; patient characteristics; sacubitril/valsartan.

MeSH terms

  • 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
  • Biphenyl Compounds
  • Blood Pressure
  • Body Mass Index
  • Comorbidity
  • Drug Combinations
  • Electronic Health Records / statistics & numerical data
  • Female
  • Germany
  • Glycated Hemoglobin / 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*
  • Valsartan

Substances

  • Adrenergic beta-Antagonists
  • Aminobutyrates
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Biphenyl Compounds
  • Drug Combinations
  • Glycated Hemoglobin A
  • Peptide Fragments
  • Tetrazoles
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Valsartan
  • sacubitril and valsartan sodium hydrate drug combination