Lipid-lowering medication shows benefit in T1D

  • Hero C & al.
  • BMJ Open Diabetes Res Care
  • 1 ene. 2020

  • de Miriam Tucker
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • In adults with type 1 diabetes (T1D), high refill adherence to lipid-lowering treatment (LLT) is associated with a lower risk for nonfatal cardiovascular disease (CVD), while discontinuation is linked to increased risk.

Why this matters

  • Role of LLT adherence in T1D has not been well-studied.

Study design

  • Swedish retrospective nationwide study of 6192 adults with T1D, followed from 2006-2010 through 2013.
  • Refill adherence was calculated by medication possession ratio (MPR).
  • Funding: Grants from the Swedish state.

Key results

  • Mean MPR over 18 months was 72% during 18-month exposure assessment period.
    • 52% participants had MPR >80%. 
    • 27% discontinued LLT.
  • Mean follow-up: of 3.6 years for nonfatal events; 3.9 years for fatal events.
  • During follow-up: 637 nonfatal CVD events, 58 fatal CVD events, and 302 deaths for other causes. 
  • Patients with MPR >80% had a 22% lower risk for nonfatal CVD compared with patients with MPR ≤80%.
  • Patients discontinuing LLT had a 43% higher risk for nonfatal CVD.
  • Those with MPR >80% had a nonsignificantly increased risk for fatal CVD (HR, 1.96; P=.06).

Limitations

  • Observational study, residual confounding possible.
  • Adherence after prescription fills unknown.
  • Healthier people may be more adherent.
  • People with multiple medications dispensed were excluded.