Single pill treatment in daily practice is associated with improved clinical outcomes and all-cause mortality in cardiovascular diseases: results from the START project

Abstract Objective Current guidelines for the management of arterial hypertension, dyslipidemia, or secondary cardiovascular (CV) prevention recommend combination drug treatments with single pill combinations (SPC). This concept is expected to improve adherence treatment and, as a consequence, reduce risk adverse CV outcomes associated these clinical conditions. Aim our study was assess whether SPC are clinically superior multi (MPC) identical drugs in reducing events and al-cause mortality huge population under real world conditions daily practice. Methods We analyzed an anonymized claims dataset (AOK PLUS, statutory German sickness fund) including patients hypertension other diseases years 2012–2017; minimum follow-up 1 year until date death, After 1:1-Propensity Score Matching (PSM), selected (myocardial infarction, stroke, transitory ischemic attack, coronary artery disease, heart failure, acute renal hospitalization, all cause hospitalization) well all-cause were compared using Incidence Rate Ratios (IRRs) non-parametric tests. Results 50,622 (25,311 versus MPC group) aged ≥18 treated followed up at least death. No significant differences baseline characteristics observed after PSM. Nine different each group. In comparisons, significantly lower incidence rate ratios (IRR) identified SPC, confirmed by comparison Kaplan-Meier estimates: stroke (IRR=0.77; 95% CI 0.67–0.88; p<0.001), attack (IRR=0.61; 0.48–0.78; myocardial infarction (IRR=0.76; 0.63–0.90; p=0.0016), disease (IRR=0.66; 0.57–0.77; failure (IRR=0.59; 0.54–0.64; (IRR=0.54; 0.56–0.64; p<0.001) hospitalization (IRR=0.72; 0.71–0.74; (IRR=0.63; 0.57–0.69; (IRR=0.62; 0.57–0.68; p<0.001). The mean time first death also favor (any event: 966.052 days/median 873; 846.936 647; death: 1,719.424 days; 1,657.248 log rank both comparisons: Conclusion practice, regimen mortality. Time event longer group MPC. These results strongly support implementation into practice patient's prognosis. Funding Acknowledgement Type funding sources: Private company. Main source(s): APONTIS PHARMA GmbH & Co. KG