OBJECTIVE: To describe treatment patterns and possible statin intolerance among high-risk Japanese population.
METHODS: A retrospective cohort study examined adults initiating either a statin or ezetimibe from 1/1/2006-5/31/2014 in the Japan Medical Data Center database (2005-2015). The first observed statin or ezetimibe prescription defined the index date. Patients had ≥12 months of pre- and post-index date plan enrollment, with all patients followed for 12 months. High-risk patients were stratified into mutually exclusive subgroups: (1) atherosclerotic cardiovascular disease (ASCVD) cohort; and (2) diabetes cohort (no previous ASCVD, but previous diabetes diagnosis). Treatment patterns and possible statin intolerance were described using previously published claims-based algorithm.
RESULTS: 40,421 patients were included (mean (SD) age: 52.1 [9.5] years, 64.2% male). Diabetes (33.2%) and hypertension (32.3%) were the most prevalent comorbidities at index. Among patients with previous ASCVD initiating statin and/or ezetimibe therapy (n= 5302), 36.7% discontinued index therapy; 7.7% switched to a non-index statin or non-statin lipid-lowering therapy and 11.2% augmented in the one year post-index period. Among patients with previous ASCVD initiating statin therapy, only 0.3% were using higher than moderate intensity statins and 10% had possible statin intolerance. Similar results were seen within the diabetes cohort.
CONCLUSIONS: Among Japanese population with ASCVD, considerable proportion discontinued statin/ezetimibe with rare use of higher than moderate intensity statins, and about 10% had possible statin intolerance.
