Efficacy of sacubitril/valsartan versus olmesartan in Japanese patients with essential hypertension: a randomized, double-blind, multicenter study

Rakugi, Hiromi; Kario, Kazuomi; Yamaguchi, M.; Sasajima, Takayoshi; Gotou, Hiromi; Zhang, Jack

doi:10.1038/s41440-021-00819-7

Cited by 45 publications

(46 citation statements)

References 35 publications

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“…Even when we set the cost at ¥20,000/month, the ICER was approximately ¥3.5 million/QALY, still under the threshold value of ¥5 million/QALY ( Figure 2 ). Recently, sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor), a novel antihypertensive drug, was approved for hypertension management in Japan 34 , with a medication cost of ¥6,057 ($52.67) to ¥12,114 ($105.34) /month. Thus, the DTx cost we set around ¥10,000/month as the default might be a reasonable value according to the current simulation model.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of digital therapeutics for essential hypertension

Nomura

Tanigawa²,

Kario

et al. 2022

Preprint

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BackgroundHypertension increases the risk of cardiovascular and other diseases. Lifestyle modification is a significant component of nonpharmacological treatments for hypertension. We previously reported the clinical efficacy of digital therapeutics (DTx) in the HERB-DH1 trial. However, there is still a lack of cost-effectiveness assessments evaluating the impact of prescription DTx. This study aimed to analyze the cost-effectiveness of using prescription DTx in treating hypertension.MethodsWe developed a monthly cycle Markov model and conducted Monte Carlo simulations using the HERB-DH1 trial data to investigate quality-adjusted life-years (QALYs) and the cost of DTx for hypertension plus guideline-based lifestyle modification consultation treatment as usual (TAU), comparing DTx+TAU and TAU-only groups with a lifetime horizon. The model inputs were obtained from the HERB-DH1 trial, published or publicly available data, and expert assumptions. The incremental cost-effectiveness ratio (ICER) per QALY was used as the benchmark for cost-effectiveness. We performed probabilistic sensitivity analyses (PSAs) using the Monte Carlo simulation with 2 million sets.ResultsThe DTx+TAU strategy produced 18.778 QALY and was associated with ¥3,924,075 ($34,122) expected costs, compared with 18.686 QALY and ¥3,813,358 ($33,160) generated by the TAU-only strategy over a lifetime horizon, resulting in an ICER of ¥1,199,880 ($10,434)/QALY gained for DTx+TAU. The monthly cost and attrition rate of DTx for hypertension have a significant impact on ICERs. In the PSA, the probability of the DTx arm being a cost-effective option was 87.8% at a threshold value of ¥5 million ($43,478)/QALY gained.ConclusionsThe DTx+TAU strategy was more cost-effective than the TAU-only strategy.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of digital therapeutics for essential hypertension

Nomura

Tanigawa²,

Kario

et al. 2022

Preprint

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“…[86][87][88][89] Other sodium-excerting drugs such as angiotensin receptor-neprilysin inhibitors (ARNI) and sodium-glucose co-transporter 2 (SGLT2) inhibitors, both of which are proven therapies for heart failure, are also effective in lowering BP. [90][91][92][93][94][95][96][97] SGLT2 inhibitors also decrease 24-hour BP in patients who have both diabetes and hypertension. [98][99][100][101] ARNI have recently been launched for the treatment of hypertension in Japan and China.…”

Section: Choice Of Preferred Antihypertensive Agentsmentioning

confidence: 99%

Seven‐action approaches for the management of hypertension in Asia – The HOPE Asia network

Kario

Chia

Siddique

et al. 2022

J of Clinical Hypertension

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Asia is a large continent and there is significant diversity between countries and regions. Over the last 30 years, absolute blood pressure (BP) levels in Asia have increased to a greater extent than those in other regions. In diverse Asia-Pacific populations, for choosing an Asia-specific approach to hypertension management is important to prevent target organ damage and cardiovascular diseases. In this consensus document of HOPE Asia Network, we introduce seven action approaches for management of hypertension in Asia.

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“…The detailed characteristics of 16 studies (10,19,20,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) are shown in Table 1. Most of the data are come from ClinicalTrials.gov, 14 trials are multi-center and 12 trials are aimed at patients with HF.…”

Section: Study Characteristicsmentioning

confidence: 99%

Effect of Sacubitril/Valsartan on Reducing the Risk of Arrhythmia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Wang

et al. 2022

Front. Cardiovasc. Med.

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Background and ObjectiveRelevant data of PARADIGM-HF reveals sacubitril/valsartan (SV) therapy led to a greater reduction in the risks of arrhythmia, and sudden cardiac death than angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor inhibitor (ARB) therapy in HFrEF, however, inconsistent results were reported in subsequent studies. Here, we conduct a meta-analysis of related randomized controlled trials (RCTs) to evaluate the protective effect of SV on reducing the risk of arrhythmias.Methods and ResultsRCTs focused on the difference in therapeutic outcomes between SV and ACEI/ARB were searched from PUBMED, EMBASE, ClinicalTrials.gov, and Cochrane Library. The results were extracted from each individual study, expressed as binary risk, 95% confidence interval (CI) and relative risk (RR). Sixteen RCTs including 22, 563 patients met the study criteria. Compared with ACEI/ARB therapy, SV therapy did significantly reduce in the risks of severe arrhythmias among patients with heart failure with reduced ejection fraction (HFrEF) (RR 0.83, 95% CI 0.73–0.95, p = 0.006), ventricular tachycardia (VT) among patients with HFrEF (RR 0.69, 95% CI 0.51–0.92, p = 0.01), cardiac arrest among patients with heart failure (HF) (RR 0.52, 95% CI 0.37–0.73, p = 0.0002), cardiac arrest among patients with HFrEF (RR 0.49, 95% CI 0.32–0.76, p = 0.001), cardiac arrest or ventricular fibrillation (VF) among patients with HF (RR 0.63, 95% CI 0.48–0.83, p = 0.001), and cardiac arrest or VF among patients with HFrEF (RR 0.65, 95% CI 0.47–0.89, p = 0.008), but reduced the risks of arrhythmias (RR 0.87, 95% CI 0.74–1.01, p = 0.07), atrial arrhythmias (RR 0.98, 95% CI 0.83–1.16, p = 0.85), and atrial fibrillation (RR 0.98, 95% CI 0.82–1.17, p = 0.82) among all patients with no significant between-group difference. The merged result was robust after sensitivity analysis, and there was no publication bias.ConclusionOur meta-analysis provides evidence that, compared with ACEI/ARB, SV can additionally reduce the risks of most arrhythmias, just the significant differences are revealed in reducing the risks of VT, severe arrhythmias, and cardiac arrest in patients with HFrEF. Besides, the positive effect of SV on VF according to statistical result of combining VF with cardiac arrest in patients with HFrEF is credibility.

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Efficacy of sacubitril/valsartan versus olmesartan in Japanese patients with essential hypertension: a randomized, double-blind, multicenter study

Cited by 45 publications

References 35 publications

Cost-effectiveness of digital therapeutics for essential hypertension

Cost-effectiveness of digital therapeutics for essential hypertension

Seven‐action approaches for the management of hypertension in Asia – The HOPE Asia network

Effect of Sacubitril/Valsartan on Reducing the Risk of Arrhythmia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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