Single pill combination therapy was projected to reduce mortality by 2.3% to 5.4% and clinical events by 4.9% to 11.5% compared with current treatment practices over 10 years.
Does single pill combination (SPC) therapy improve mortality and clinical events in patients with hypertension compared to multi-pill regimens?
Ten-year microsimulation projections suggest that single pill combination therapy for hypertension improves adherence and significantly reduces mortality and cardiovascular events compared to conventional multi-pill management strategies across five countries.
OBJECTIVE: To project the 10-year clinical outcomes associated with single pill combination (SPC) therapies compared with multi-pill regimens for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico). METHODS: A microsimulation model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices (CTP), single drug with dosage titration then sequential addition of other agents (start low and go slow, SLGS), free choice combination with multiple pills (FCC) and combination therapy in the form of a single pill (SPC). Model inputs were derived from the Global Burden of Disease 2017 dataset. Simulated outcomes of mortality, chronic kidney disease (CKD), stroke, ischemic heart disease (IHD), and disability-adjusted life years (DALYs) were estimated for 1,000,000 patients on each treatment pathway. RESULTS: SPC therapy was projected to improve clinical outcomes over SLGS, FCC and CTP in all countries. SPC reduced mortality by 5.4% in Italy, 4.9% in Russia, 4.5% in China, 2.3% in South Korea and 3.6% in Mexico versus CTP and showed greater reductions in mortality than SLGS and FCC. The projected incidence of clinical events was reduced by 11.5% in Italy, 9.2% in Russia, 8.4% in China, 4.9% in South Korea and 6.7% in Mexico for SPC versus CTP. CONCLUSIONS: Ten-year projections indicated that combination therapies (FCC and SPC) are likely to reduce the burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence.
Borghi et al. (Wed,) conducted a other in Hypertension (n=1,000,000). Single pill combination (SPC) therapy vs. Current treatment practices (CTP), start low and go slow (SLGS), and free choice combination (FCC) was evaluated on 10-year mortality and clinical events. Single pill combination therapy was projected to reduce mortality by 2.3% to 5.4% and clinical events by 4.9% to 11.5% compared with current treatment practices over 10 years.
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