德国降脂疗法的治疗途径 2016-2022年
Julius L Katzmann1, Claudia Grellmann2, Beate Leppert3
1Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. julius.katzmann@medizin.uni-leipzig.de.
概括
德国大多数患有高心血管风险的患者,尽管有可用的降脂疗法 (LLT),但无法达到LDL胆固醇目标. 治疗变化很少发生,他类药物主导了最初的处方,较新的药物,如bempedoic acid (BA) 和PCSK9抑制剂 (PCSK9i) 较少使用.
科学领域:
- 心血管医学 心血管医学
- 药物治疗 药物治疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 有效的降低LDL胆固醇 (LDL-C) 的药物可供使用,但少数患者达到指南推的治疗目标.
- 了解降脂疗法 (LLT) 的治疗途径对于改善德国心血管风险管理至关重要.
研究的目的:
- 分析德国高或非常高心血管风险患者的降脂疗法 (LLT) 治疗途径.
- 评估不同类型的LLT的利用模式,切换和停止率.
主要方法:
- 德国2016-2022年健康声明数据的分析.
- 包括接受LLT的高/非常高心血管风险患者.
- 检查治疗途径,切换时间和停止治疗他类药物,ezetimibe,bempedoic acid (BA) 和PCSK9抑制剂 (PCSK9i).
主要成果:
- 类药物是主要的第一线LLT (96.3%),以西西米布,BA和PCSK9i不经常使用 (<1%).
- 在LLT开始后,治疗方案的改变并不常见.
- 与他类药物和ezetimibe相比,BA和PCSK9i主要被用作附加疗法;与他类药物和ezetimibe相比,BA的停止时间较早 (0.60年),而PCSK9i的停止时间较晚 (2.45年).
结论:
- 在德国,在高风险患者中,LLT的治疗修改是罕见的.
- 与他类药物和ezetimibe相比,佩多酸 (BA) 和PCSK9抑制剂 (PCSK9i) 显示出不同的停止模式.
- 需要持续努力来增强长期坚持和克服治疗惯性,以最大限度地发挥现有的LLT的好处.
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