PCV27 - HEART FAILURE SIGNS AND SYMPTOMS AND REFERRALS TO HOSPITAL ARE REDUCED FOLLOWING SACUBITRIL/VALSARTAN TREATMENT IN THE PRIMARY CARE AND CARDIOLOGIST SETTING IN GERMANY

Assess changes in HF symptoms and referrals to hospital among patients treated with sacubitril/valsartan (sac/val) in the primary care (PC) and cardiologist setting in Germany. Electronic medical records from 1108 PC and 41 Cardiologist practices from the German IMS Disease Analyzer database identified patients (≥18 years) with a sac/val prescription (Rx) between 01/01/2016 and 31/12/2016, from practices with continuous data delivery since study initiation (01/01/2015), and with minimum 6 months of post-index data available (min 1 Rx following index date). Baseline characteristics were defined during the 12 months pre-index. The following HF signs and symptoms were evaluated during 90 days pre-index and 31-120 post-index (allowing for 30 days up-titration) through ICD-10 codes and free text searches: dyspnoea, pulmonary oedema, peripheral oedema, fatigue, chest pain, nausea, cough. McNemar’s and Wilcoxon signed-rank test were used to compare pre- and post-index periods for the same patients. 1263 patients with a sac/val Rx were identified, with mean±standard deviation (SD) age of 71±12 years, 69% male. Prescribed dose of sac/val at index was 50 mg bid in 62%, 100 mg bid in 31% and 200 mg bid in 7%. Signs and symptoms were reported at an overall low frequency (<15%) in both the pre- and post-index. Major HF symptoms were reported more frequently before than after sac/val index (p<0.05): peripheral oedema (3.7% vs 2.4%), dyspnoea (5.8% vs 2.1%), and chest pain (13% vs. 9%). Significantly fewer referrals to hospital (all-cause) occurred after sac/val index compared to prior index (19% vs. 10%, p<0.001) and the mean number of hospital referrals was approximately halved (p<0.001). The reduction trend was observed across specialty and sac/val dose at index. Fewer HF symptoms and referrals to hospital (all-cause) were observed after treatment with sac/val, consistently across specialty and sac/val dose levels at index.