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Adherence and Intensity of Lipid-Lowering Therapy Influences CV Risk

MONDAY, Dec. 17, 2018 -- Adherent patients receiving high-intensity statin and/or ezetimibe therapy have the lowest cardiovascular risk, according to a study published online Dec. 7 in JAMA Network Open.

Kamlesh Khunti, M.D., 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 versus 57.4 percent in year 1; 72.3 versus 48.4 percent 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 percent lower for each 10 percent 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.

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Posted: December 2018

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