Patients with dyslipidemia and type 1 diabetes with high vs low adherence to lipid-lowering therapy were found to be at lower risk for nonfatal cardiovascular disease (CVD), according to study results published in BMJ Open Diabetes Research and Care.
In this population-based, retrospective study, researchers followed 6192 patients with type 1 diabetes who initiated lipid-lowering therapy between 2006 and 2010. Refill adherence was estimated 18 months after initiation by calculating the medication possession ratio (MPR). Lipid-lowering therapy nonpersistence (ie, no medicine in hand for ≥180 days) and discontinuation were also assessed. Patients were followed until CVD occurrence, death, or end of follow-up period (December 2013).
The mean MPR was 72%±28% (median, 83%). Approximately 52% of patients had an MPR >80% (median, 97%), and 27% of patients discontinued LLT. The respective mean follow-up durations for the 637 nonfatal CVD events and 58 fatal CVD events in this population were 3.6 and 3.9 years, respectively. Patients with an MPR >80% had a reduced risk for nonfatal CVD compared with patients with MPR <80% (hazard ratio [HR], 0.78; 95% CI, 0.65-0.93). Patients who discontinued lipid-lowering therapy had a higher risk for nonfatal CVD compared with patients who adhered to therapy throughout follow-up (HR, 1.43; 95% CI, 1.18-1.73).
Limitations of the study include its observational and retrospective nature as well as the lack of information regarding actual prescription consumption.
“It is important to evaluate and emphasize adherence to prescribed lipid-lowering therapy in clinical practice to achieve treatment goals and reduce the risk [for] CVD in individuals with type 1 diabetes,” noted the study authors.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Hero C, Karlsson SA, Franzén S, et al. Adherence to lipid-lowering therapy and risk for cardiovascular disease and death in type 1 diabetes mellitus: a population-based study from the Swedish National Diabetes Register. BMJ Open Diabetes Res Care. 2020;8(1).