Key result
Aliskiren was prescribed as monotherapy in 49.4% of hypertensive patients and as combination therapy in 50.6%, most commonly replacing another antihypertensive drug (71.9%).
Observational (n=5,411)
Yes
In real-world French practice, aliskiren is frequently used to replace other antihypertensives and is prescribed alone in about half of cases, generally following prescribing recommendations.
Aliskiren substitution patterns in French practice warrant monitoring; observational data leave open optimal long-term role in hypertension.
OBJECTIVES: The aim of this French observational study was to evaluate how the direct renin inhibitor aliskiren is being prescribed to treat hypertension by primary care providers (PCPs) and office-based cardiologists. METHODS: Each participating physician included the first three consecutive hypertensive patients who had been prescribed aliskiren at least 4 weeks beforehand and noted whether aliskiren was prescribed: alone or as part of a combination; as first-line therapy, to replace another drug or as an add-on therapy. RESULTS: Five thousand, four hundred and eleven patients were analyzed [mean age, 63; 58% men; 24% diabetic; mean blood pressure (BP) 148/85 mmHg]. A total of 23.6% of patients had a controlled BP. Aliskiren was prescribed alone in 49.4% patients and as part of a combination in 50.6% (bitherapy 28.3%, tritherapy 14.7%, and quadri+therapy 7.6%), at the higher recommended dosage (300 mg daily) to two-thirds of cases. Aliskiren replaced another drug in 71.9% [mainly an angiotensin receptor blocker (ARB) or an angiotensin-converting enzyme inhibitor (ACEi)] and was added to an existing regimen in 22.5%. For bitherapy, aliskiren was combined with a diuretic (D; 39%) or a calcium channel blocker (CCB; 32%). For tritherapy, it was prescribed with CCB and D in 28% and β-blocker and D in 26%. In 8.9% of patients, aliskiren was prescribed with an ACEi or an ARB. CONCLUSION: French physicians are generally following the current prescribing recommendations for aliskiren, but the place of this new class of antihypertensive in the management of essential hypertension will become clearer with longer experience, especially concerning effective doses and combinations.
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Sosner et al. (2013) conducted an observational in Essential hypertension (n=5,411). Aliskiren was evaluated on Prescribing patterns of aliskiren (alone, combination, first-line, replacement, or add-on). Aliskiren was prescribed as monotherapy in 49.4% of hypertensive patients and as combination therapy in 50.6%, most commonly replacing another antihypertensive drug (71.9%).
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