Use of sacubitril/valsartan in patients with heart failure: evidence from the real world

Expert Opin Pharmacother. 2023 Sep-Dec;24(18):2211-2219. doi: 10.1080/14656566.2023.2287667. Epub 2024 Jan 5.

Abstract

Background: To characterize the use of sacubitril/valsartan in a group of patients with heart failure in Colombia.

Research design and methods: Follow-up study of patients with heart failure who started sacubitril/valsartan and were affiliated with the Colombian health system between 2019 and 2021. Sociodemographic, clinical, and pharmacological variables and adherence and persistence of use were identified.

Results: A total of 514 patients were identified, with a mean age of 65.7 years, 73.7% of whom started sacubitril/valsartan at low doses, and only 12.5% reached the maximum dose. Adherence was 78.2% and persistence was 56.8% at 1 year of follow-up. The increase in systolic blood pressure (odds ratio (OR): 1.01; 95% CI: 1.00-1.03) and the use of β-blockers (OR: 2.63; 95% CI: 1.42-4.85) were correlated with a greater persistence, while receiving furosemide (OR: 0.59; 95% CI: 0.39-0.89) and not having received renin - angiotensin - aldosterone system inhibitors in the 3 months before starting sacubitril/valsartan (OR: 0.48; 95% CI: 0.31-0.76) were associated with lower persistence.

Conclusions: The persistence of treatment 1 year after starting sacubitril/valsartan was not high, and a small proportion of patients reached the target dose of the drug. Nontitration of the drug dose was common.

Keywords: Colombia; Heart failure; medication adherence; pharmacoepidemiology; sacubitril valsartan drug combination.

MeSH terms

  • Aged
  • Aminobutyrates / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Biphenyl Compounds / therapeutic use
  • Drug Combinations
  • Follow-Up Studies
  • Heart Failure* / drug therapy
  • Humans
  • Stroke Volume / physiology
  • Tetrazoles* / therapeutic use
  • Treatment Outcome
  • Valsartan / therapeutic use

Substances

  • sacubitril
  • Tetrazoles
  • Angiotensin Receptor Antagonists
  • Valsartan
  • Aminobutyrates
  • Biphenyl Compounds
  • Drug Combinations