Effects of Single Pill Combinations Compared to Identical Multi Pill Therapy on Outcomes in Hypertension, Dyslipidemia and Secondary Cardiovascular Prevention: The START-Study
Wilke T, Weisser B, Predel HG, Schmieder R, Wassmann S, Gillessen A, Blettenberg J, Maywald U, Randerath O, Mueller S, Böhm M (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 15
Pages Range: 11-21
DOI: 10.2147/IBPC.S336324
Abstract
Aim: Current guidelines for the treatment of arterial hypertension (AH) or cardiovascular (CV) prevention recommend combination drug treatments with single pill combinations (SPC) to improve adherence to treatment. We aimed to assess whether the SPC concept is clinically superior to multi pill combination (MPC) with identical drugs. Methods and Results: In an explorative study, we analyzed anonymized claims data sets of patients treated with CV drugs for hypertension and/or CV disorders who were insured by the German AOK PLUS statutory health fund covering 01/07/2012-30/06/2018. Patients at age ≥18 years who received either a SPC or MPC with identical drugs were followed for up to one year. A one to one propensity score matching (PSM) was applied within patient groups who started identical drug combinations, and results were reported as incidence rate ratios (IRRs) as well as hazard ratios (HRs). After PSM, data from 59,336 patients were analyzed. In 30 out of 56 IRR analyses, superiority of SPC over MPC was shown. In 5 out of 7 comparisons, the HR for the composite outcome of all-cause death and all-cause hospitalizations was in favor of the SPC regimen (SPC versus MPC): valsartan/amlodipine: HR=0.87 (95% CI: 0.84–0.91, p ≤ 0.001); candesartan/amlodipine: 0.77 (95% CI: 0.65– 0.90, p = 0.001); valsartan/amlodipine/hydrochlorothiazide: HR=0.68 (95% CI: 0.61–0.74, p ≤ 0.001); ramipril/amlodipine: HR=0.80 (95% CI: 0.77–0.83, p ≤ 0.001); acetylsalicylic acid (ASA)/atorvastatin/ramipril: HR=0.64 (95% CI: 0.47–0.88, p = 0.005). Conclusion: SPC regimens are associated with a lower incidence of CV events and lower all-cause mortality in clinical practice. SPC regimens should generally be preferred to improve patient’s prognosis.
Authors with CRIS profile
Involved external institutions
Institut für Pharmakoökonomie und Arzneimittellogistik e.V. (IPAM)
Germany (DE)
Christian-Albrechts-Universität zu Kiel
Germany (DE)
Deutsche Sporthochschule Köln
Germany (DE)
Universitätsklinikum des Saarlandes (UKS)
Germany (DE)
Herz-Jesu-Krankenhaus Hiltrup
Germany (DE)
APONTIS PHARMA GmbH & Co. KG
Germany (DE)
Ingress-Health HWM GmbH
Germany (DE)
Germany (DE)
Christian-Albrechts-Universität zu Kiel
Germany (DE)
Deutsche Sporthochschule Köln
Germany (DE)
Universitätsklinikum des Saarlandes (UKS)
Germany (DE)
Herz-Jesu-Krankenhaus Hiltrup
Germany (DE)
APONTIS PHARMA GmbH & Co. KG
Germany (DE)
Ingress-Health HWM GmbH
Germany (DE)
How to cite
APA:
Wilke, T., Weisser, B., Predel, H.G., Schmieder, R., Wassmann, S., Gillessen, A.,... Böhm, M. (2022). Effects of Single Pill Combinations Compared to Identical Multi Pill Therapy on Outcomes in Hypertension, Dyslipidemia and Secondary Cardiovascular Prevention: The START-Study. Integrated Blood Pressure Control, 15, 11-21. https://doi.org/10.2147/IBPC.S336324
MLA:
Wilke, Thomas, et al. "Effects of Single Pill Combinations Compared to Identical Multi Pill Therapy on Outcomes in Hypertension, Dyslipidemia and Secondary Cardiovascular Prevention: The START-Study." Integrated Blood Pressure Control 15 (2022): 11-21.
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