Key result
Disopyramide use in oHCM remains very low, staying under ~6% annually across European cohorts.
Why the study?
Guidelines recommend disopyramide for obstructive HCM when symptoms persist, but data on its real-world use beyond single-center experience are very limited.
What is the real-world usage rate of disopyramide in patients with obstructive hypertrophic cardiomyopathy in Europe?
Observational (n=11,694)
Yes
What is the real-world usage rate of disopyramide in patients with obstructive hypertrophic cardiomyopathy in Europe?
Real-world use of disopyramide for obstructive hypertrophic cardiomyopathy is very low in Europe, suggesting significant barriers to its implementation despite guideline recommendations.
Answers are grounded in this paper and cite their sources.
Low disopyramide use signals implementation gaps in obstructive HCM; leaves open reasons for underutilization and effects on outcomes.
Background/Objectives: Guidelines for obstructive hypertrophic cardiomyopathy (HCM) recommend treatment with disopyramide as an add-on to beta-blockers or calcium-channel blockers when symptoms persist. Data pertaining to effective disopyramide use in practice beyond single-center experience are very limited. This study aimed to quantify disopyramide use in patients with obstructive HCM in England, France and Germany, before the availability of cardiac myosin inhibitors. Methods: This retrospective study used nationally representative databases from England (Clinical Practice Research Datalink and Hospital Episode Statistics, 2010–2019), France (National Healthcare Data System, 2012–2019) and Germany (German statutory health insurance, 2011–2019). Adults (18+) with obstructive HCM were included, based on diagnostic codes for obstructive HCM or any HCM with septal reduction therapy. Disopyramide usage was defined as ≥1 prescription for a patient in a calendar year. Results: Overall, 3730, 6823 and 1141 patients diagnosed with obstructive HCM were identified in the English, French and German databases, respectively. In England, disopyramide use ranged from 4.7% to 5.6% per year with use generally stable over time. The equivalent usage for France was 1.7% to 2.6% per year. As expected, no recorded reimbursed use was reported in Germany during the study period. Conclusions: Disopyramide use is very low in patients with obstructive HCM, possibly due to treatment-related issues, availability or lack of reimbursement. These barriers may drive the uptake of alternative guideline recommended therapies for obstructive HCM treatment.
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Charron et al. (2024) conducted an observational in obstructive hypertrophic cardiomyopathy (n=11,694). Disopyramide was evaluated on Disopyramide usage (≥1 prescription for a patient in a calendar year). Disopyramide use in adults with obstructive hypertrophic cardiomyopathy was very low, ranging from 4.7% to 5.6% per year in England, 1.7% to 2.6% in France, and 0% in Germany.
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