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).

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Limitations of the study include its observational and retrospective nature as well as the lack of information regarding actual prescription consumption.


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 “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.

Reference

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).

This article originally appeared on The Cardiology Advisor