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

<p><b>Objectives</b>: 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.</p> <p><b>Methods</b>: 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 (<i>n</i> = 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 (<i>n</i> = 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.</p> <p><b>Results</b>: 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 (<i>p</i> < 0.001) in NT-proBNP and glycated haemoglobin levels were observed following sac/val initiation.</p> <p><b>Conclusions:</b> 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.</p

Proportion of patients with “1”, “2–11”, “12–23”, and “24+” LABA containing-prescriptions in 2008, for all patients with LABA-containing prescriptions (a), asthma patients with LABA-containing prescriptions (b), COPD patients with LABA-containing prescriptions (c), and asthma and COPD patients with LABA-containing prescriptions (d) (AHC: Mondriaan–AHC, NPCRD: Mondriaan–NPCRD).

<p>Proportion of patients with “1”, “2–11”, “12–23”, and “24+” LABA containing-prescriptions in 2008, for all patients with LABA-containing prescriptions (a), asthma patients with LABA-containing prescriptions (b), COPD patients with LABA-containing prescriptions (c), and asthma and COPD patients with LABA-containing prescriptions (d) (AHC: Mondriaan–AHC, NPCRD: Mondriaan–NPCRD).</p

Comparison of annual period prevalence rate (PPR) of LABA-containing prescriptions in 7 European databases stratified by age and sex for the year 2008.

<p>LABA: Long-acting beta-2-agonist.</p><p>CI: Confidence interval.</p><p>*Age group: 0–19 years</p><p>Comparison of annual period prevalence rate (PPR) of LABA-containing prescriptions in 7 European databases stratified by age and sex for the year 2008.</p

Main characteristics of databases.

<p>Main characteristics of databases.</p