Use of sacubitril/valsartan in patients with heart failure: evidence from the real world

Abstract

Background: To characterize the use of sacubitril/valsartan in a group of patients with heart failure in Colombia. Research design and methods: Follow-up study of patients with heart failure who started sacubitril/valsartan and were affiliated with the Colombian health system between 2019 and 2021. Sociodemographic, clinical, and pharmacological variables and adherence and persistence of use were identified. Results: A total of 514 patients were identified, with a mean age of 65.7 years, 73.7% of whom started sacubitril/valsartan at low doses, and only 12.5% reached the maximum dose. Adherence was 78.2% and persistence was 56.8% at 1 year of follow-up. The increase in systolic blood pressure (odds ratio (OR): 1.01; 95% CI: 1.00–1.03) and the use of β-blockers (OR: 2.63; 95% CI: 1.42–4.85) were correlated with a greater persistence, while receiving furosemide (OR: 0.59; 95% CI: 0.39–0.89) and not having received renin–angiotensin–aldosterone system inhibitors in the 3 months before starting sacubitril/valsartan (OR: 0.48; 95% CI: 0.31–0.76) were associated with lower persistence. Conclusions: The persistence of treatment 1 year after starting sacubitril/valsartan was not high, and a small proportion of patients reached the target dose of the drug. Nontitration of the drug dose was common.