scholarly journals Az atorvastatin/amlodipin fix kombináció versus az atorvastatinterápia a terápiahűség tükrében

2016 ◽  
Vol 157 (11) ◽  
pp. 425-429 ◽  
Author(s):  
Gábor Simonyi ◽  
Tamás Ferenci
Keyword(s):  
Survival Analysis ◽  
Fixed Dose Combination ◽  
Combination Method ◽  
Fixed Dose ◽  
Pharmacy Claims ◽  
Significant Difference ◽  
Atorvastatin Therapy ◽  
Dose Combination ◽  
One Year ◽  
The One

Introduction: Hypertension and dyslipidemia are modifiable cardiovascular risk factors. In Hungary hypertension and dyslipidemia are quite frequent conditions. The patients’ adherence is very important factor to reach the targets. Aim: The aim of the authors was to investigate the one-year persistence of the atorvastatin therapy and atorvastatin and amlodipine fixed dose combination. Method: National Health Insurance Found prescriptions database of Hungary on pharmacy claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for atorvastatin and amlodipine fixed dose combination and atorvastatin prescribed for the first time. Patients did not receive similar drugs for one year before the study. To model the persistence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. Results: During the trial period, atorvastatin and atorvastatin plus amlodipine fixed dose combination was started in 192,579 and 24,433 patients, respectively. One year persistence rate in patients with atorvastatin and amlodipine fixed dose combination was 43%, and 21% in patients with atorvastatin therapy. The 360-days-restricted study period, the mean duration of persistence was 221.4 (SE: 0.894) days in patients on atorvastatin and amlodipine fixed dose combination and 153.0 days (SE: 0.297) in those on atorvastatin regimen. The hazard of discontinuation was almost twofold higher during treatment with atorvastatin therapy compared with the use of the atorvastatin and amlodipine fixed dose combination (hazard ratio = 1.85, p<0.0001). Conclusions: There is a significant difference between the one-year persistence of atorvastatin therapy and atorvastatin plus amlodipine fixed dose combination. The result demonstrate that atorvastatin and amlodipine fixed dose combination is favourable to reach double goals on blood pressure and LDL-cholesterol. Orv. Hetil., 2016, 157(11), 425–429.

scholarly journals A perindopril/amlodipin szabad és fix kombinációk egyéves terápiahűsége

2017 ◽  
Vol 158 (36) ◽  
pp. 1421-1425
Author(s):  
Gábor Simonyi ◽  
Tamás Ferenci ◽  
Mihály Medvegy ◽  
Roland Gasparics ◽  
Ervin Finta
Keyword(s):  
Survival Analysis ◽  
Antihypertensive Therapy ◽  
Patient Adherence ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Cardiovascular Risk Reduction ◽  
Pharmacy Claims ◽  
Dose Combination ◽  
One Year ◽  
The One

Abstract: Introduction: In management of hypertension patient adherence is one of the most important factors. In hypertension the cardiovascular risk reduction can be reached only by prolonged and effective pharmacotherapy. Aim: To evaluate the persistence of one-year treatment of free and fixed-dose combination of perindopril/amlodipine in hypertension. Method: Information from the National Health Insurance of Hungary prescriptions database on pharmacy claims between October 1, 2012 and September 30, 2013 was analysed. Authors identified patients who filled prescriptions for free and fixed-dose combination of perindopril/amlodipine, prescribed for the first time for hypertension. Patients have not received antihypertensive therapy with similar active substances during the one year before. Apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied. Results: 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.

scholarly journals A ramipril/amlodipin és a lisinopril/amlodipin fix kombinációk a terápiahűség tükrében

2016 ◽  
Vol 157 (1) ◽  
pp. 30-34
Author(s):  
Gábor Simonyi ◽  
Tamás Ferenci
Keyword(s):  
Blood Pressure ◽  
Survival Analysis ◽  
Antihypertensive Therapy ◽  
Target Blood Pressure ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Significant Difference ◽  
Dose Combination ◽  
One Year ◽  
The One

Introduction: Patient’s adherence has a great significance to reach target blood pressure values. The risk of cardiovascular adverse events decreases when patients are on target blood pressure. Aim: The aim of the authors was to investigate the one-year persistence of the ramipril/amlodipine and lisinopril/amlodipine fixed dose combination in hypertensive patients. Method: National Health Insurance Found prescriptions database of Hungary on pharmacy-claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for fixed dose combinations of ramipril and amlodipine, and lisinopril and amlodipine prescribed for the first time, for the therapeutic indication of hypertension. Patients have not received antihypertensive therapy with similar active substances during one year before the study. To model the persistence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. Results: During the study period, fixed dose combination antihypertensive therapy with ramipril plus amlodipine and lisinopril plus amlodipine was started in 10,449 and 20,276 patients, respectively. One-year persistence rate in patients taking ramipril and amlodipine as a fixed dose combination was 54%, whereas 36% in those on the fixed lisinopril and amlodipine combination. Considering only the 360-day study period, the mean duration of persistence was 271 days in patients on the ramipril based and 211 days on lisinopril based fixed dose combination. Analyzing persistence on treatment with these combinations showed that the actual rate of discontinuation was about twice higher during treatment with the lisinopril and amlodipine fixed dose combination compared with the use of the ramipril and amlodipine fixed dose combination (hazard ratio = 1.79, p<0.001). Conclusions: There is a significant difference between the one-year persistence of ramipril plus amlodipine and lisinopril plus amlodipine fixed dose combination in patients with hypertension. The result demonstrated that ramipril and amlodipine fixed dose combination has a favourable patients’ adherence as compared to lisinopril and amlodipine fixed dose combination. Orv. Hetil., 2016, 157(1), 30–34.

scholarly journals A ramipril versus ramipril/amlodipin fix kombináció egyéves perzisztenciája hypertoniás betegekben

2017 ◽  
Vol 158 (42) ◽  
pp. 1669-1673 ◽  
Author(s):  
Gábor Simonyi ◽  
Tamás Ferenci
Keyword(s):  
Blood Pressure ◽  
Survival Analysis ◽  
Combination Therapy ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Hypertensive Patients ◽  
Persistence Rate ◽  
Dose Combination ◽  
One Year ◽  
The One

Abstract: Introduction: In the treatment of hypertension avoiding adverse cardiovascular complications to achieve target blood pressure is essential. The appropriate drug selection, and if necessary to change to combination therapy, patients adherence is important which may help fixed dose combination. Aim: The aim of the authors was to investigate the one year adherence of the ramipril and ramipril/amlodipine fixed dose combination in hypertensive patients. Method: Prescriptions database of the National Health Insurance Fund in Hungary on pharmacy-claims was analysed between October 1, 2012 and September 30, 2013. The authors identified patients who filled prescriptions for ramipril monotherapy and fixed dose combinations of ramipril/amlodipine prescribed for the first time in hypertensive patients who have not received similar drugs in the previous year. To model the adherence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. Results: 92,546 patients met the inclusion criteria. During the trial period, ramipril therapy or ramipril/amlodipine fixed dose combination was started in 82,251 and 10,295 patients, respectively. One year persistence rate in patients with ramipril was 30% and 54% in patients with ramipril/amlodipine fixed dose combination therapy. Considering only the 360-day study period, the mean duration of persistence was 189.9 days in patients on ramipril and 270.6 days on ramipril/amlodipine fixed dose combination therapy. The hazard of discontinuation was more than twofold higher during treatment with ramipril compared with the use of the ramipril/amlodipine fixed dose combination therapy (HR = 2.11 [95% CI: 2.05–2.17], p<0,001). Conclusions: There is a significant difference between the one year persistence of ramipril and ramipril/amlodipine fixed dose combination therapy in hypertension. The result demonstrated that ramipril/amlodipine fixed dose combination therapy has a better one year persistence rate. When the next step is necessary to achieve target blood pressure, ramipril/amlodipine fixed dose combination therapy is preferable. Orv Hetil. 2017; 158(42): 1668–1673.

scholarly journals A metformin-monoterápia és a szitagliptin/metformin fix kombináció egyéves perzisztenciája

2016 ◽  
Vol 157 (16) ◽  
pp. 618-622
Author(s):  
Gábor Simonyi ◽  
Tamás Ferenci
Keyword(s):  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Metformin Monotherapy ◽  
Dose Combination ◽  
One Year ◽  
The One ◽  
Type 2 Diabetic

Introduction: In treatment of type 2 diabetes mellitus it is important to reach glycaemic targets. The elements of this are the adequate diet and the patient’s adherence to medication. Aim: The aim of the authors was to investigate the one year persistence of the metformin monotherapy and sitagliptin/metformin fixed dose combination in type 2 diabetic patients. Method: National Health Insurance Found prescriptions database of Hungary on pharmacy-claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for metformin monotherapy and fixed dose combinations of sitagliptin/metformin prescribed for the first time. Patients have not received similar drugs one year previous to study. To model the persistence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied: a generalized linear model was estimated with complementary log-log link function with the kind of drug being the only explanatory variable. Results: During the trial period, metformin monotherapy or sitagliptin/metformin fixed dose combination was started in 63,386 and 10,039 patients, respectively. One year persistence rate in patients with metformin monotherapy was 30%, and 58% in patients with sitagliptin/metformin fixed dose combination. Considering only the 360-day study period, the mean duration of persistence was 173.4 days in patients on metformin monotherapy and 261.9 days on sitagliptin/metformin fixed dose combination. The hazard of discontinuation was more than twofold higher during treatment with metformin monotherapy compared with the use of the sitagliptin/metformin fixed dose combination (hazard ratio = 2.267, p<0.001). Conclusions: There is a significant difference between the one year persistence of metformin monotherapy and sitagliptin/metformin fixed dose combination in type 2 diabetic patients. The result demonstrated sitagliptin/metformin fixed dose combination has a favourable patients’ adherence as compared to metformin monotherapy. Orv. Hetil., 2016, 157(16), 618–622.

P4561Patients adherence with fixed dose combinations of renin-angiotensin-aldosterone system inhibitors in hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G A Simonyi ◽  
T Ferenci ◽  
E Finta ◽  
S Balogh ◽  
M Medvegy
Keyword(s):  
Renin Angiotensin System ◽  
Fixed Dose ◽  
Channel Blockers ◽  
Hypertensive Patients ◽  
Renin Angiotensin ◽  
Pharmacy Claims ◽  
Persistence Rate ◽  
Significant Difference ◽  
One Year ◽  
Ras Inhibitors

Abstract Introduction The latest ESC/ESH guidelines recommended fixed dose combinations (FDC) for first therapy in hypertension. Preferred two-drug combinations are a RAS (renin–angiotensin system) blocker with a CCBs (calcium channel blockers) or a diuretic. There are no available data about these FDCs adherence in hypertension. Aim To assess one year persistence of recommended FDCs (RAS-inhibitors/CCBs or diuretics) in hypertensive patients. Method Prescriptions database of National Health Insurance Found in Hungary on pharmacy-claims were analysed between October 1, 2012 and September 30, 2013. We identified patients who filled prescriptions for FDCs of RAS-inhibitors/CCBs or diuretics prescribed for the first time in hypertensive patients who have not received similar drugs during one year before. To model the persistence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. Results 443,149 patients met the inclusion criteria. One-year persistence rate and hazard ratio (HR) of discontinuation (reference was ACEi/indapamide FDC) in patients with ACEi/CCB FDCs (n=124,154) was 44,95% (HR=0.69, [CI: 0.68–0.69], p<0.0001), ARB/HCT FDCs (n=109,707) was 42,52% (HR=0.80, [CI: 0.81–0.83], p<0.0001), ACEi/indapamide FDC (n=127,757) was 37,27% (HR=1.00, reference), ARB/CCB FDCs (n=13,542) was 29.04% (HR=1.19, [CI: 1.17–1.22], p<0.0001) and ACEi/HCT FDCs (n=67,989) was 27.47% (HR=1.17, [CI: 1.15–1.18], p<0.0001). One year peristence of FDCs Conclusions We have found significant difference between FDC s of RAS-inhibitors in hypertensive in relation of patients adherence. Our result demonstrated that ACEi/CCBs FDC therapy has the best one year persistence rate.

scholarly journals One Year of Netarsudil and Latanoprost Fixed-Dose Combination for Elevated Intraocular Pressure

2020 ◽  
Vol 3 (5) ◽  
pp. 327-338
Author(s):  
Jacob W. Brubaker ◽  
Savak Teymoorian ◽  
Richard A. Lewis ◽  
Dale Usner ◽  
Hayley J. McKee ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Elevated Intraocular Pressure ◽  
Dose Combination ◽  
One Year

scholarly journals Beneficial Effects of Fixed-Dose Combination of Amlodipine and Atorvastatin in Patients with Concomitant Hypertension and Hypercholesterolemia: A Multi-Institutional Cohort Study

2021 ◽  
Author(s):  
Chia-Pin Lin ◽  
Fu-Chih Hsiao ◽  
Chia-Tung Wu ◽  
Yu-Sheng Lin ◽  
Shao-Wei Chen ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Clinical Results ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Beneficial Effects ◽  
Significant Difference ◽  
Dose Combination ◽  
Concomitant Hypertension

Abstract Background Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are important risk factors for cardiovascular (CV) diseases and treating these factors simultaneously is recommended by current guidelines but only short-term clinical results were available. The objective of this study was to examine the longer-term efficacy and safety of fixed-dose combination (FDC) versus free combination of amlodipine and atorvastatin in patients with concomitant hypertension and hypercholesterolemia. Methods Patients with hypertension and hypercholesterolemia were stratified into three groups (FDC of amlodipine 5 mg/atorvastatin 10 mg [Fixed 5/10], FDC of amlodipine 5 mg/atorvastatin 20 mg [Fixed 5/20], and free combination of amlodipine 5 mg/atorvastatin 10 mg [Free 5/10]). After inverse probability of treatment weighting, the composite CV outcome, liver function, BP, LDL-C and glycated hemoglobin (HbA1c) changes were compared. Results A total of 1,788 patients were eligible for analysis and the mean follow-up period was 1.7 year. There was no significant difference in the composite CV outcome among the three groups during the 30-month follow-up period (Fixed 5/10 6.1%, Fixed 5/20 6.3% and Free 5/10 6.0%). The LDL-C level was significantly reduced in the Fixed 5/20 group (-35.7 mg/dL) compared to the Fixed 5/10 (-23.6 mg/dL) and Free 5/10 (-10.3 mg/dL) groups (P=0.001 and <0.001, respectively). The changes in HbA1c were similar among the three groups. Conclusions FDC of amlodipine and atorvastatin, especially the regimen with higher dosage of statin, significantly reduced the mid-term LDL-C level compared to free combination in patients with concomitant hypertension and hypercholesterolemia. Blood sugar level during the follow-up period was not significantly changed by this aggressive treatment strategy.

scholarly journals The novel bronchodilator navafenterol: a phase 2a, multi-centre, randomised, double-blind, placebo-controlled crossover trial in COPD

2021 ◽  
pp. 2100972
Author(s):  
Dave Singh ◽  
Jutta Beier ◽  
Carol Astbury ◽  
Maria G. Belvisi ◽  
Carla A. Da Silva ◽  
...  
Keyword(s):  
Adverse Events ◽  
Mean Difference ◽  
Beta Agonist ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Double Blind ◽  
Once Daily ◽  
Significant Difference ◽  
Dose Combination ◽  
Severe Copd

BackgroundNavafenterol (AZD8871) belongs to a new class of bronchodilator, the single-molecule muscarinic antagonist and beta agonist (MABA), being developed for the treatment of chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the efficacy, pharmacokinetics and safety of navafenterol versus placebo and an active comparator treatment for moderate-to-severe COPD.MethodsThis phase 2a, randomised, multicentre (Germany and UK), double-blind, double-dummy, three-way complete crossover study (ClinicalTrials.gov identifier: NCT03645434) compared 2 weeks’ treatment of once-daily navafenterol 600 µg via inhalation with placebo and a fixed-dose combination bronchodilator (umeclidinium/vilanterol [UMEC/VI]; 62.5 µg/25 µg) in participants with moderate-to-severe COPD. The primary outcome was change from baseline in trough FEV1 on day 15. Secondary endpoints included: change from baseline in peak FEV1; change from baseline in breathlessness, cough and sputum scale (BCSS); change from baseline in COPD assessment tool (CAT); adverse events; and pharmacokinetics.ResultsSeventy-three participants were randomised. After 14 days, trough FEV1 was significantly improved with navafenterol compared with placebo (least-squares [LS] mean difference 0.202 L; p<0.0001). There was no significant difference in FEV1 between navafenterol and UMEC/VI (LS mean difference −0.046 L; p=0.075). COPD symptoms (CAT and BCSS) showed significantly greater improvements with both active treatments versus placebo (all p<0.005). Novel objective monitoring (VitaloJAK) showed that cough was reduced with both active treatments compared with placebo. Safety profiles were similar across the treatment groups and no serious adverse events were reported in the navafenterol treatment period.ConclusionOnce-daily navafenterol was well tolerated, improved lung function and reduced COPD-related symptoms, similar to an established once-daily fixed-dose combination bronchodilator.

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