Real-World Evidence on the Use of Secondary Prevention for People With ASCVD or CKD: A Systematic Literature Review
Author(s)
Magnus Fugger, MD1, Balamurali Kalyanam, MD, MBA1, Anna Okkels, MSc2, Emma Munk, MSc2, Mette Boegelund, PhD2, Hongye Ren, MPH, MD1;
1Novo Nordisk A/S, Søborg, Denmark, 2EY Godkendt Revisionspartnerselskab, Copenhagen, Denmark
1Novo Nordisk A/S, Søborg, Denmark, 2EY Godkendt Revisionspartnerselskab, Copenhagen, Denmark
OBJECTIVES: Atherosclerotic cardiovascular disease (ASCVD) is caused by plaque buildup, leading to conditions as coronary artery disease, cerebrovascular disease, and peripheral artery disease. A recognized ASCVD risk factor is chronic kidney disease (CKD), and secondary prevention of CKD and ASCVD is therefore crucial for improving long-term outcomes. This systematic literature review aimed to explore clinical practices by identifying real-world evidence (RWE) on the use of secondary prevention for ASCVD and CKD globally.
METHODS: A systematic search was conducted in PubMed and Embase to identify eligible publications from 2004 onward. Two independent reviewers used a two-step blinded process to screen the publications based on predefined criteria. Eligible publications presented RWE on secondary prevention in adults in selected countries. Specific medications were categorized into five treatment areas: anti-glycemic, anti-hypertensive, anti-inflammatory, anti-thrombotic, and lipid-lowering.
RESULTS: The search identified 18 and 8 publications for ASCVD and CKD, respectively. For ASCVD, commonly reported treatments included anti-hypertensives, antiplatelet therapy and statins. Use of mineralocorticoid receptor antagonists (MRA) and glucagon-like peptide 1 (GLP-1) were also reported. Angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) usage ranged from 43.9% (China) to 81.0% (Sweden). Antiplatelet therapy ranged from 7.5% (Canada) to 99% (Sweden), and statin usage from 23.0% (Japan) to 95.7% (US). For CKD, the most frequently reported treatments was anti-hypertensives. ACEi/ARB usage ranged from 2.2% (Australia) to 81.0% (US). Other treatments included sodium-glucose cotransporter-2 inhibitors (SGLT2i) (<1% (several countries) to 17.9% (Canada)), MRA (3.0% (Canada) to 9.0% (Sweden)), and GLP-1 (3.2% to 4.2% (both US)).
CONCLUSIONS: The results indicate that the real-world usage of secondary prevention strategies for CKD and ASCVD varies considerably across countries. These differences might be due to variations in national guidelines and healthcare systems. Further research is needed to understand the clinical practices in depth and to develop strategies for optimizing secondary prevention globally.
METHODS: A systematic search was conducted in PubMed and Embase to identify eligible publications from 2004 onward. Two independent reviewers used a two-step blinded process to screen the publications based on predefined criteria. Eligible publications presented RWE on secondary prevention in adults in selected countries. Specific medications were categorized into five treatment areas: anti-glycemic, anti-hypertensive, anti-inflammatory, anti-thrombotic, and lipid-lowering.
RESULTS: The search identified 18 and 8 publications for ASCVD and CKD, respectively. For ASCVD, commonly reported treatments included anti-hypertensives, antiplatelet therapy and statins. Use of mineralocorticoid receptor antagonists (MRA) and glucagon-like peptide 1 (GLP-1) were also reported. Angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) usage ranged from 43.9% (China) to 81.0% (Sweden). Antiplatelet therapy ranged from 7.5% (Canada) to 99% (Sweden), and statin usage from 23.0% (Japan) to 95.7% (US). For CKD, the most frequently reported treatments was anti-hypertensives. ACEi/ARB usage ranged from 2.2% (Australia) to 81.0% (US). Other treatments included sodium-glucose cotransporter-2 inhibitors (SGLT2i) (<1% (several countries) to 17.9% (Canada)), MRA (3.0% (Canada) to 9.0% (Sweden)), and GLP-1 (3.2% to 4.2% (both US)).
CONCLUSIONS: The results indicate that the real-world usage of secondary prevention strategies for CKD and ASCVD varies considerably across countries. These differences might be due to variations in national guidelines and healthcare systems. Further research is needed to understand the clinical practices in depth and to develop strategies for optimizing secondary prevention globally.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD151
Topic
Real World Data & Information Systems
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Urinary/Kidney Disorders