TY - JOUR
T1 - Treatment and low-density lipoprotein cholesterol levels in patients with hypercholesterolaemia or mixed dyslipidaemia at high or very high cardiovascular risk
T2 - a population-based cross-sectional study in the Netherlands
AU - Heintjes, Edith M.
AU - Anastassopoulou, Anastassia
AU - Kuiper, Josephina
AU - Bilitou, Aikaterini
AU - Beest, Fernie J. A. Penning-van
AU - Herings, Ron M. C.
AU - Postma, Maarten J.
AU - Jukema, J. Wouter
N1 - Funding Information: This study was funded by Daiichi Sankyo Europe GmbH. Daiichi was involved in all stages of this study from protocol development to submission of the manuscript. Data processing and analyses were performed by the PHARMO Institute for Drug Outcomes Research. Funding Information: The authors would like to thank all the healthcare providers contributing information to the PHARMO Database Network. They would like to acknowledge support from Evi van Ekris of the PHARMO Institute for data processing, from Michael Kerschnitzki of Daiichi Sankyo Europe for manuscript review, and from Carina Dinkel-Keuthage of Daiichi Sankyo Europe for manuscript review and data visualization. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Objective: To describe treatment patterns, low-density lipoprotein cholesterol (LDL-C) levels and healthcare resource utilization (HCRU) in the Netherlands in 2018 of patients with hypercholesterolaemia or mixed dyslipidaemia at high or very high cardiovascular (CV) risk. Methods: From the PHARMO Database Network adult patients with a diagnosis or receiving lipid lowering therapy (LLT) between 2009 and 2018 were selected. Patients at high or very high CV risk according to 2016 ESC/EAS guidelines with recorded LDL-C levels who were treated with LLT or were characterized as statin intolerant in 2018 were included. LLT treatment patterns, LDL-C levels and HCRU (General Practitioner [GP] consultations and hospitalizations) were assessed. Results: The study population included 54,346 patients, of which 70% were at very high CV risk and 30% at high CV risk. The majority (93%) received statin monotherapy, mostly of moderate (73%) or high (15%) intensity. Only 3% received a combination of statin and ezetimibe. Statin intolerance, based on a treatment algorithm, was estimated at 3%. Average LDL-C decreased with LLT intensity. Overall, 74% reached LDL-C < 2.5 mmol/l and 34% <1.8 mmol/l with their current treatment, and 46% reached their LDL-C goal according to 2016 ESC/EAS guidelines. The highest rates of hospitalizations and GP consultations, including home visits, were recorded in patients with peripheral artery disease or polyvascular disease. Conclusion: The treatment of hypercholesterolaemia and mixed dyslipidaemia in patients at high or very high CV risk in the Netherlands was suboptimal in 2018. To further lower CV risk alternative treatment strategies using add-on therapies are needed.
AB - Objective: To describe treatment patterns, low-density lipoprotein cholesterol (LDL-C) levels and healthcare resource utilization (HCRU) in the Netherlands in 2018 of patients with hypercholesterolaemia or mixed dyslipidaemia at high or very high cardiovascular (CV) risk. Methods: From the PHARMO Database Network adult patients with a diagnosis or receiving lipid lowering therapy (LLT) between 2009 and 2018 were selected. Patients at high or very high CV risk according to 2016 ESC/EAS guidelines with recorded LDL-C levels who were treated with LLT or were characterized as statin intolerant in 2018 were included. LLT treatment patterns, LDL-C levels and HCRU (General Practitioner [GP] consultations and hospitalizations) were assessed. Results: The study population included 54,346 patients, of which 70% were at very high CV risk and 30% at high CV risk. The majority (93%) received statin monotherapy, mostly of moderate (73%) or high (15%) intensity. Only 3% received a combination of statin and ezetimibe. Statin intolerance, based on a treatment algorithm, was estimated at 3%. Average LDL-C decreased with LLT intensity. Overall, 74% reached LDL-C < 2.5 mmol/l and 34% <1.8 mmol/l with their current treatment, and 46% reached their LDL-C goal according to 2016 ESC/EAS guidelines. The highest rates of hospitalizations and GP consultations, including home visits, were recorded in patients with peripheral artery disease or polyvascular disease. Conclusion: The treatment of hypercholesterolaemia and mixed dyslipidaemia in patients at high or very high CV risk in the Netherlands was suboptimal in 2018. To further lower CV risk alternative treatment strategies using add-on therapies are needed.
KW - Hypercholesterolaemia
KW - antihyperlipidaemics
KW - atherosclerotic cardiovascular disease
KW - high cardiovascular risk
KW - low-density lipoprotein cholesterol
KW - mixed dyslipidaemia
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85145242046&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36168818
U2 - https://doi.org/10.1080/03007995.2022.2129228
DO - https://doi.org/10.1080/03007995.2022.2129228
M3 - Article
C2 - 36168818
SN - 0300-7995
VL - 39
SP - 1
EP - 11
JO - Current medical research and opinion
JF - Current medical research and opinion
IS - 1
ER -