Adherence and Intensity of Lipid-Lowering Tx Influence CV Risk

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Lowest risk seen for adherent patients receiving high-intensity statin and/or ezetimibe regimen
Lowest risk seen for adherent patients receiving high-intensity statin and/or ezetimibe regimen

(HealthDay News) -- Adherent patients receiving high-intensity statin and/or ezetimibe therapy have the lowest cardiovascular risk, according to a study published online in JAMA Network Open.

Kamlesh Khunti, MD, from the University of Leicester in the United Kingdom, and colleagues examined the correlation between adherence and treatment intensity and cardiovascular outcomes in a retrospective cohort study. Patients had documented cardiovascular disease (CVD), type 2 diabetes without CVD or chronic kidney disease (CKD), or CKD without CVD and were newly treated with their first statin and/or ezetimibe prescription between Jan. 1, 2010, and Dec. 31, 2013.

The researchers found that in the documented CVD cohort, patients receiving high-intensity therapy were more likely than those receiving low-intensity therapy to be adherent over time (84.1 vs 57.4% in year 1; 72.3 vs 48.4% in year 68). They also found a graded association with both low-density lipoprotein cholesterol reduction and CVD outcomes using a combined measure of adherence and treatment intensity: The risk was 10% lower for each 10% increase in the combined measure (hazard ratio, 0.90). The lowest risk was seen for adherent patients receiving a high-intensity regimen (hazard ratio, 0.60) compared with patients untreated for one year or longer.

"The basic message here is that long-term adherence achieves better long-term cholesterol reductions, and in turn, achieves better long-term outcomes for patients," a coauthor said in a statement.

Several authors disclosed financial ties to pharmaceutical companies, including Amgen; the study was funded by Amgen Europe GmbH.

Reference

Khunti K, Danese MD, Kutikova L, et al. Association of a Combined Measure of Adherence and Treatment Intensity With Cardiovascular Outcomes in Patients With Atherosclerosis or Other Cardiovascular Risk Factors Treated With Statins and/or Ezetimibe. JAMA Netw Open. 2018;1(8):e185554. DOI:10.1001/jamanetworkopen.2018.5554

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