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New Analysis of CHARM Programme Provides Key Insights into Patient Adherence to Heart Failure Medication

Data Adds to Growing Body of Evidence that Adherence Can Reduce the Risk of Death and Hospitalisation

MÖLNDAL, SWEDEN -- December 7, 2005 -- AstraZeneca today announced that the December 10th issue of The Lancet published results of an analysis of the Candesartan in Heart failure Assessment of Reduction in Mortality and Morbidity (CHARM) Programme, which demonstrated that adherence to medication in heart failure patients resulted in a lower risk of death compared with patients who did not take their medication as prescribed.

"The new CHARM Programme analysis advances current knowledge about the effect that adherence to medication has on clinical outcomes in heart failure patients," said lead author Dr. Bradi B. Granger of Duke University Medical Center and Duke University School of Nursing. "By educating their patients on the importance of adherence, healthcare professionals have the opportunity to help improve the management of heart failure patients, thus increasing their chances for survival."

The analysis included 7599 heart failure patients randomly assigned to Atacand® (candesartan cilexetil), an angiotensin II receptor blocker (ARB), or placebo. For all patients, good adherence was associated with lower all-cause mortality (HR 0.65, 95% CI 0.58-0.76, P <.001) and fewer hospital admissions for heart failure. Overall, 89% of patients were at least 80% adherent (defined as having taken blinded study medication as prescribed), and adherence was similar for patients taking Atacand and patients taking placebo. The analysis also identified several factors associated with poor adherence, including female gender, smoking, higher heart rate and more comorbid conditions1.

"Although numerous studies have shown that medications and lifestyle modifications reduce the risk of mortality for heart failure patients, adherence to these regimens is often below optimum," Dr Anders Svensson, VP, External Scientific Affairs, Cardiovascular at AstraZeneca commented. "A number of barriers exist which prevent physicians incorporating the latest evidenced-based ESC guidelines to helping improve patient adherence to treatment. AstraZeneca is committed to support doctors in their aim to improve the management of heart failure."

Previously presented data from the CHARM Programme, demonstrates a significant reduction in deaths and CHF hospital admissions in favour of Atacand®. A pre-specified analysis in the group of CHARM patients with heart failure and reduced LVEF (n=4576; LVEF </= 40%), the 'classic' heart failure population studied in major clinical trials, demonstrated a 12% relative risk reduction in all cause deaths (P =.018) and a 16% relative risk reduction in cardiovascular deaths (P =.005) when Atacand® was added to standard treatment2. With 29 deaths avoided per 1,000 treated patients investigators concluded that Atacand® should be considered in all patients with CHF and a low LVEF. The effect of treatment with Atacand® was similar irrespective of background treatment with ACE-inhibitors, beta blockers or spironolactone.

Atacand is now approved for the treatment of heart failure in 49 countries, including the EU and US.

Candesartan cilexetil is marketed by AstraZeneca under trademark Atacand®, Ratacand®, and is manufactured under the license from Takeda Pharmaceutical Company Ltd.

REFERENCES:
1. Granger BB, et al. Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme: double-blind, randomized, controlled clinical trial. Lancet 2005;366: 2005-2011.

2. Young JB, Dunlap ME, Pfeffer MA, Probsfield JL, Cohen-Solal A, Dietz R et al. Mortality and morbidity reduction with candesartan in patients with chronic heart failure and left ventricular systolic function. Results from the CHARM low-left ventricular ejection fraction trials. Circulation 2004;110:2618-26.


SOURCE: AstraZeneca

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