Abstract

Objective

To investigate whether statin adherence (defined as proportion days covered, PDC) is associated with LDL-c response in statin initiators on standard and low starting doses of statins, and to detect a possible interaction with sex.

Methods

An inception cohort study was conducted using the PharmLines Initiative, a linkage between the Lifelines Cohort Study and the University of Groningen’s IADB.nl (prescription database). First-time statin users were followed from baseline to follow-up measurement. We matched participants (1:1) between the standard-dose and the low-dose group of statin users on the duration of follow-up. Multiple linear regression analysis was used to model the association.

Results

In univariate analysis, PDC was significantly associated with LDL-c response similarly (slope = −0.021), in both the standard-dose group (N = 115, p < .001) and the low-dose group (N = 115, p = .003). In the standard-dose group, the same level of PDC appeared to be significantly associated with a greater LDL-c level reduction in women (slope = −0.027, N = 48, p < .001) than in men (slope = −0.017, N = 67, p < .001). Meanwhile, in the low-dose group, the reduction of LDL-c level from baseline seemed to be greater in men (slope = −0.023, N = 56, p < .001) than in women (slope = −0.020, N = 59, p < .001) for the same level of PDC. In multiple regression analysis, the significant association between PDC and LDL-c with a similar pattern to the univariate result was maintained only in the standard-dose group.

Conclusions

Adherence is significantly associated with LDL-c response to statins at follow-up. Sex appears to significantly modify this association. At a similar adherence level, women seem to experience a better LDL-c response to standard-dose statins compared to men in a real-world setting.

中文翻译：

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标准剂量和低剂量他汀类药物首次使用者对他汀类药物治疗的依从性与低密度脂蛋白胆固醇 (LDL-c) 反应之间的关联：PharmLines 倡议

摘要

客观的

调查他汀类药物依从性（定义为覆盖天数，PDC）是否与他汀类药物起始者对标准和低起始剂量他汀类药物的 LDL-c 反应相关，并检测可能与性别的相互作用。

方法

使用 PharmLines Initiative 进行了一项初始队列研究，这是 Lifelines Cohort Study 和格罗宁根大学 IADB.nl（处方数据库）之间的链接。首次使用他汀类药物的用户从基线到后续测量进行跟踪。我们在随访期间匹配标准剂量和低剂量他汀类药物使用者组的参与者 (1:1)。多元线性回归分析用于对关联进行建模。

结果

在单变量分析中，在标准剂量组 ( N  = 115, p  < .001) 和低剂量组 ( N  = 115, p  = .003)。在标准剂量组中，与男性相比，相同水平的 PDC 似乎与女性（斜率 = -0.027，N  = 48，p  < .001）更大的 LDL-c 水平降低相关（斜率 = -0.017 , N  = 67, p  < .001)。同时，在低剂量组中，男性 LDL-c 水平较基线的降低似乎更大（斜率 = -0.023，N  = 56，p < .001) 比相同水平的 PDC 的女性 (斜率 = -0.020, N  = 59, p  < .001)。在多元回归分析中，PDC 和 LDL-c 之间的显着关联与单变量结果的模式相似，仅在标准剂量组中得以维持。

结论

依从性与随访时对他汀类药物的 LDL-c 反应显着相关。性似乎显着改变了这种关联。在相似的依从性水平上，与现实世界中的男性相比，女性似乎对标准剂量他汀类药物的 LDL-c 反应更好。