Ramipril + amlodipine and ramipril + hydrochlorothiazide fixed-dose combinations in relation to patient adherence

Simonyi, Gábor; Ferenci, Tamás; Alföldi, Sándor; Farsang, Csaba

doi:10.1177/0300060516645004

Cited by 9 publications

(5 citation statements)

References 20 publications

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“…All 29 studies reported on adherence and/or persistence in patients taking SPC therapy for hypertension. Four studies were RCTs (14%) [35,37,38,46]; the remainder (n ¼ 25; 86%) were observational studies [14,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]36,[39][40][41][42][43][44][45]47] (Table S3, http://links.lww.com/HJH/B268). Sample sizes varied considerably, from n ¼ 75 to n ¼ 79 958 for SPC therapy and n ¼ 73 to n ¼ 383 269 for free-dose combination therapy.…”

Section: Study Populations and Antihypertensive Therapy Prescribedmentioning

confidence: 99%

Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes: a rapid evidence assessment of recent literature

Tsioufis

Kreutz

Sykara

et al. 2020

Journal of Hypertension

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The 2018 European Society of Cardiology/ European Society of Hypertension Guidelines for the management of arterial hypertension raised the need for evidence to support the use of single-pill combination (SPC) therapy in preference to free-dosed therapy for hypertension. This systematic rapid evidence assessment sought to determine if initiating SPC therapy improves adherence, blood pressure (BP) control and/or cardiovascular outcomes vs. initiation of free-dose combination therapy. Methods: Rapid evidence assessment conducted in MEDLINE, EMBASE, and Cochrane Library (1 January 2013-11 January 2019) to identify studies investigating SPC therapy for adults with hypertension. Information on adherence/persistence, BP lowering/goal attainment, and cardiovascular outcomes/events were extracted via twophase screening process. Studies not focusing on adherence, persistence, or compliance with SPC therapy were excluded. Methodological quality was assessed using appropriate scales. Results: Of 863 citations, 752 failed to meet inclusion or were duplicates. Twenty-nine studies remained following full-text screening. Just four studies (14%) were randomized controlled studies; 25 (86%) were observational. A range of SPC therapies were studied, with calcium channel blocker/angiotensin receptor blocker combinations most common (11/29 studies). Adherence and persistence were generally higher with SPC vs. freedose combination therapy; 15 studies (54%) directly compared adherence and four (14%) compared persistence. Patients achieving BP targets ranged from 25 to 89%. Despite all studies investigating patients with hypertension only 16 (55%) reported change in BP. Few studies reported on cardiovascular outcomes. Methodological reporting was often suboptimal. Conclusion: Adherence and/or persistence were generally higher in patients taking antihypertensives as SPC vs. freedose combination; however, methodological reporting was suboptimal to facilitate comparison. Specifically designed, well reported studies are required to determine if the increased adherence/persistence seen in patients on SPC regimen leads to improved BP control and/or cardiovascular outcomes.

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Section: Study Populations and Antihypertensive Therapy Prescribedmentioning

confidence: 99%

Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes: a rapid evidence assessment of recent literature

Tsioufis

Kreutz

Sykara

et al. 2020

Journal of Hypertension

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“…A hazai [10,11] és a nemzetközi adatok [12] egyaránt azt igazolták, hogy az egyes vérnyomáscsökkentő készítmények szabad és fix kombinációinak terápiahűsége között átlagosan 20 százalékpontos különbség is lehet, mégpedig a fix kombinációk javára. Mindezek miatt a fix kombinációkat kell előtérbe helyezni az antihypertensiv terápiában [4].…”

Section: Eredeti Közleményunclassified

Az angiotenzinkonvertálóenzim-gátló/kalciumcsatorna-blokkoló fix gyógyszer-kombinációk egyéves perzisztenciája hypertoniában

et al. 2019

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Introduction: The most recent European guidelines for the treatment of hypertension suggest the use of renin-angiotensin-aldosterone system antagonists (RAAS inhibitors) and calcium channel blockers (CCBs) or diuretics fixed-dose combinations (FDCs) as the first therapeutic option. In antihypertensive therapy, the patient’s adherence is one of the most important factors in reducing unwanted cardiovascular events. Aim: Our aim was to assess the one-year persistence of angiotensin-converting enzyme inhibitor (ACEI) and CCB FDCs in hypertensive patients. Method: Authors have analysed the prescription database of the National Health Insurance Fund in Hungary on pharmacy claims between October 1, 2012 and September 30, 2013. Those patients were identified who filled prescriptions for FDCs of ACEI and CCBs prescribed for the first time for hypertensive patients and who had not received similar drugs during the year before. Apparatus of survival analysis was used, where ‘survival’ was the time to abandon the medication. Results: 124 388 patients met the inclusion criteria. One-year persistence rate and hazard ratio (HR) of discontinuation in patients with ramipril/amlodipine FDC was 54% (HR = 1.00, reference), perindopril/amlodipine 47% (HR = 1.30, p<0.0001), lisinopril/amlodipine 36% (HR = 1.79, p<0.0001), ramipril/felodipine 26% (HR = 2.28, p<0.0001) and trandolapril/verapamil 12% (HR = 4.13, p<0.0001). The average survival time of drug limited to 360 days was 270.2 days for ramipril/amlodipine FDC, 242.7 days for perindopril/amlodipine FDC, 211.2 days for lisinopril/amlodipine FDC, 186.3 days for ramipril/felodipine FDC and 125.7 days for trandolapril/verapamil FDC. Conclusions: The authors demonstrated that the one-year persistence of ACEI/CCB FDCs was significantly different in hypertensive patients. Ramipril/amlodipine FDC was more advantageous for patient adherence. Orv Hetil. 2019; 160(9): 343–348.

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“…Egy másik hazai vizsgálatunkban egy korszerű ACE-gátló/kalciumcsatornablokkoló és egy ACE-gátló/hidroklorotiazid (HCT) fix kombináció egyéves perzisztenciáját vettük górcső alá. E vizsgálatunkban a több mint 39 000 beteg követése alatt a ramipril/HCT fix kombináció egyéves terápiahűségét 29%-nak találtuk, míg a ramipril/amlodipin fix kombináció perzisztenciája a korábbiaknak megfelelően 54% volt [11]. Eredményünk szerint a ramiprilalapú fix kombinációk közül a ramipril/amlodipin fix kombináció 25 százalékponttal -szignifikánsan -magasabb terápiahűséggel rendelkezett, és ennek megfelelően a ramipril/ HCT elhagyásának kockázata -a ramipril/amlodipin fix kombinációhoz képest -több mint kétszeres volt (HR: 2,318, p<0,001).…”

Section: áBraunclassified

A perindopril/amlodipin szabad és fix kombinációk egyéves terápiahűsége

et al. 2017

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109,248 patients met the inclusion criteria. Combination antihypertensive therapy with perindopril/amlodipine was started with a free or a fixed-dose combination of these agents in 19,365 and 89,883 patients, respectively. One year persistence rate in patients taking perindopril/amlodipine as a free combination was 27.15%, whereas it was 46.89% in those on the fixed-dose combination. Mean duration of persistence was 177.6 days in patients on the perindopril/amlodipine free, whereas 245.7 days on fixed-dose combination. Actual rate of discontinuation was approximately twice higher with the treatment of free, compared with the use of the fixed-dose combination (hazard ratio =1.94 [95% CI: 1.91-1.98], p<0.001). Orv Hetil. 2017; 158(36): 1421-1425.

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Ramipril + amlodipine and ramipril + hydrochlorothiazide fixed-dose combinations in relation to patient adherence

Cited by 9 publications

References 20 publications

Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes: a rapid evidence assessment of recent literature

Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes: a rapid evidence assessment of recent literature

Az angiotenzinkonvertálóenzim-gátló/kalciumcsatorna-blokkoló fix gyógyszer-kombinációk egyéves perzisztenciája hypertoniában

A perindopril/amlodipin szabad és fix kombinációk egyéves terápiahűsége

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