Romanelli RJ, Leahy A, Jukes T, Ye X, Kang A, Ishisaka DY., Ann Pharmacother. 47(10):1247-52. doi: 10.1177/1060028013501804., 2013 Oct 01
Persistent treatment with lipid-lowering therapies is important for achieving optimal clinical outcomes. To date, no study has evaluated the real-world use of colesevelam and the factors associated with persistent colesevelam treatment.
The primary objective of this study was to examine patient demographic and characteristics associated with persistent colesevelam treatment in real-world clinical practice.
In this retrospective cohort study, adult patients with hypercholesterolemia, an initial order for colesevelam between January 2004 and December 2011, a low-density lipoprotein cholesterol (LDL-C) value ≤ 3 months from the initial order date (baseline), and ≥ 12 months of follow-up were identified through electronic health records. Persistent treatment was defined as no medication order gap >30 days during a 12-month period. Multivariate logistic regression was performed to assess factors associated with persistent treatment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A P value <.05 was considered statistically significant.
A total of 971 patients met eligibility criteria. Forty-nine percent of patients had ≥ 12 months of persistent treatment. Multivariate analysis showed that female sex (OR = 0.69; 95% CI = 0.53, 0.90; P = .004) was associated with lesser odds of persistence, whereas baseline LDL-C at goal (1.39; 1.06, 1.82; P = .015) and concomitant use of the intestinal cholesterol absorption inhibitor ezetimibe (1.64; 1.18, 2.28; P = .003) were associated with greater odds of persistence.
This study identified several patient demographic and characteristics associated with persistent colesevelam treatment that may help develop strategies to improve treatment persistence and optimize clinical outcomes.