Treatment Adherence in a Randomized Controlled Trial of Pirfenidone in HFpEF: Determinants and Impact on Efficacy

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Abstract

<p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="first" dir="auto" id="d12255306e166">Medication adherence in patients with heart failure with preserved ejection fraction is unclear. This study sought to evaluate treatment adherence in the Pirfenidone in Patients with Heart Failure and Preserved Left Ventricular Ejection Fraction (PIROUETTE) trial. </p>

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Comparison of drug adherence rates among patients with seven different medical conditions.

Iracema S Andrade, Hassan Fouayzi, Jim K H Chan … (2008)

To compare drug adherence rates among patients with gout, hypercholesterolemia, hypertension, hypothyroidism, osteoporosis, seizure disorders, and type 2 diabetes mellitus by using a standardized approach. Longitudinal study. Health care claims data from 2001-2004. A total of 706,032 adults aged 18 years or older with at least one of the seven medical conditions and with incident use of drug therapy for that condition. Drug adherence was measured as the sum of the days' supply of drug therapy over the first year observed. Covariates were age, sex, geographic residence, type of health plan, and a comorbidity score calculated by using the Hierarchical Condition Categories risk adjuster. Bivariate statistics and stratification analyses were used to assess unadjusted means and frequency distributions. Sample sizes ranged from 4984 subjects for seizure disorders to 457,395 for hypertension. During the first year of drug therapy, 72.3% of individuals with hypertension achieved adherence rates of 80% or better compared with 68.4%, 65.4%, 60.8%, 54.6%, 51.2%, or 36.8% for those with hypothyroidism, type 2 diabetes, seizure disorders, hypercholesterolemia, osteoporosis, or gout, respectively. Age younger than 60 years was associated with lower adherence across all diseases except seizure disorders. Comorbidity burden and adherence varied by disease. As comorbidity increased, adherence among subjects with osteoporosis decreased, whereas adherence among those with hypertension, hypercholesterolemia, or gout increased. Add-on drug therapies and previous experience with taking drugs for the condition increased adherence among subjects with hypertension, type 2 diabetes, hypothyroidism, or seizure disorders but not the other conditions. This uniform comparison of drug adherence revealed modest variation across six of seven diseases, with the outlier condition being gout.

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Heart Failure with Preserved Ejection Fraction.

Margaret M. Redfield (2016)

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Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis

Lisa H. Lancaster, Joao A. de Andrade, Joseph D. Zibrak … (2017)

Pirfenidone is one of two approved therapies for the treatment of idiopathic pulmonary fibrosis (IPF). Randomised controlled clinical trials and subsequent post hoc analyses have demonstrated that pirfenidone reduces lung function decline, decreases mortality and improves progression-free survival. Long-term extension trials, registries and real-world studies have also shown similar treatment effects with pirfenidone. However, for patients with IPF to obtain the maximum benefits of pirfenidone treatment, the potential adverse events (AEs) associated with pirfenidone need to be managed. This review highlights the well-known and established safety profile of pirfenidone based on randomised controlled clinical trials and real-world data. Key strategies for preventing and managing the most common pirfenidone-related AEs are described, with the goal of maximising adherence to pirfenidone with minimal AEs. Using key strategies to prevent and manage pirfenidone-related AEs can help maximise adherence to pirfenidone http://ow.ly/Veyk30gsFTs

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FARDAD Soltani: (View ORCID Profile)

Journal

Title: Journal of Cardiac Failure

Abbreviated Title: Journal of Cardiac Failure

Publisher: Elsevier BV

ISSN (Print): 10719164

Publication date Created: July 2023

Publication date (Print): July 2023

Volume: 29

Issue: 7

Pages: 1091-1096

Article

DOI: 10.1016/j.cardfail.2023.02.010

PubMed ID: 36921885

SO-VID: e0cca231-0140-4b55-a545-82d3ebf253ad

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https://www.elsevier.com/tdm/userlicense/1.0/

http://creativecommons.org/licenses/by/4.0/

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Treatment Adherence in a Randomized Controlled Trial of Pirfenidone in HFpEF: Determinants and Impact on Efficacy

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Most cited references 10

Comparison of drug adherence rates among patients with seven different medical conditions.

Heart Failure with Preserved Ejection Fraction.

Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis

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