Key result
Originator lercanidipine was associated with higher medium-term adherence and a lower risk of the composite of all-cause mortality and cardiovascular events compared to originator amlodipine (HR 1.43).
Why the study?
Low medication adherence contributes to uncontrolled cardiovascular risk, but real-world adherence to originator versus generic dihydropyridine calcium-channel blockers was not well characterized.
Does lercanidipine originator improve medication adherence and reduce the composite of all-cause mortality and cardiovascular events compared to generic lercanidipine, amlodipine originator, and generic amlodipine in adult patients?
Cohort (n=15,808)
Yes
Does lercanidipine originator improve medication adherence and reduce the composite of all-cause mortality and cardiovascular events compared to generic lercanidipine, amlodipine originator, and generic amlodipine in adult patients?
Hazard Ratio: 1.43 (95% CI 1.28–1.6)
In a large Italian real-world cohort, originator lercanidipine was associated with higher medium-term treatment adherence and a lower hazard of all-cause mortality and cardiovascular events compared to generic lercanidipine and both originator and generic amlodipine.
INTRODUCTION: Low medication adherence contributes to uncontrolled cardiovascular (CV) risk. AIMS: This study investigated 12- and 24-month adherence, all-cause mortality and CV events in subjects receiving originator or generic dihydropyridine calcium-channel blockers (CCBs) as recorded in administrative databases from Local Health Units across several Italian regions. METHODS: We retrospectively analysed databases containing demographics and vital status, drug prescriptions, and hospital discharge diagnoses for more than 6 million individuals. Subjects receiving lercanidipine originator, generic lercanidipine, amlodipine originator, or generic amlodipine were included. Subjects with prior or occasional CCB use, inadequate follow-up time, chronic ischaemic heart disease or acute pulmonary heart disease, or switching between CCBs were excluded. Adherence was defined as a Proportion of Days Covered ≥ 80% at 12 and 24 months. Cox regression models estimated the association between treatments and a composite of all-cause mortality and CV events. RESULTS: Adherence was assessed in 3,860 propensity-score-matched subjects (965/group), selected from 14,849 eligible subjects. Lercanidipine originator was associated with higher (p < 0.001) 12-month (43%) and 24-month (38%) adherence than generic lercanidipine (31 and 26%) and amlodipine originator (22 and 19%). The events analysis included 15,808 subjects. Compared with originator lercanidipine, originator amlodipine, generic lercanidipine and generic amlodipine were associated with 43%, 30% and 33% higher hazards of the composite outcome, respectively (corresponding 95% Confidence Intervals: 1.28-1.60, 1.10-1.55, 1.17-1.50). CONCLUSIONS: Medium-term adherence was low across all treatments. Originator lercanidipine was associated with the highest adherence, with lower adjusted hazards of the composite outcome and all-cause mortality compared to the other treatments.
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Capacci et al. (2026) conducted a cohort in Hypertension (patients receiving dihydropyridine calcium-channel blockers) (n=15,808). Lercanidipine originator vs. Amlodipine originator, generic amlodipine, or generic lercanidipine was evaluated on Composite of all-cause mortality and cardiovascular events (HR 1.43 (for amlodipine originator vs lercanidipine originator), 95% CI 1.28-1.60). Originator lercanidipine was associated with higher medium-term adherence and a lower risk of the composite of all-cause mortality and cardiovascular events compared to originator amlodipine (HR 1.43).
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