Daiichi Sankyo Europe (Daiichi Sankyo) has reaffirmed its commitment to addressing unmet needs and barriers in cardiovascular (CV) care by highlighting disparities in treatment and outcomes among different patient groups. This announcement follows the presentation of new data from sub-analyses of the SANTORINI observational study and the ETNA-AF (Edoxaban Treatment in Routine Clinical Practice in Patients with Nonvalvular Atrial Fibrillation) study programme at the European Society of Cardiology (ESC) Congress 2024.
Gender Inequalities in CV Disease Treatment and LDL-C Goal Attainment
Elevated levels of low-density lipoprotein cholesterol (LDL-C) are a significant modifiable risk factor for major cardiovascular events. Research indicates that a 1 mmol/L reduction in LDL-C is associated with a 22% decrease in major cardiovascular events over one year. Data from the SANTORINI study reveal that female patients in Europe at high or very high CV risk are less likely to achieve guideline-recommended LDL-C levels compared to their male counterparts.
The SANTORINI sub-analysis included 5,197 men (mean age 65) and 2,013 women (mean age 66). Findings showed that women were less likely to be treated adequately, with fewer reaching LDL-C goals. Although the percentage of patients meeting LDL-C targets improved from baseline to the one-year follow-up, the increase was more pronounced in men (from 22.9% to 33.3%) than in women (from 16.9% to 24.6%). Additionally, a higher proportion of women did not receive lipid-lowering therapies at baseline and follow-up compared to men.
Treatment Adherence and Its Impact on Patient Outcomes
Effective treatment of atrial fibrillation with oral anticoagulants relies on patient adherence. Non-persistence with non-vitamin K antagonist oral anticoagulants (NOACs) is linked to a higher stroke risk in atrial fibrillation patients.
Daiichi Sankyo’s ETNA-AF programme, which integrates data from various non-interventional studies across Europe, East Asia, and Japan, aims to better understand the global burden of cardiovascular disease. The ETNA-AF registries, which followed over 28,000 patients (with four years of follow-up in Europe and two years outside Europe), revealed that 87.4% of the 9,417 patients who completed the study were persistent with edoxaban treatment.
The post hoc sub-analysis identified several factors associated with treatment discontinuation and non-persistence, including increasing age, male sex, body weight extremes, low renal function, heart failure, vascular disease, chronic hepatic disease, alcohol use, perceived frailty, chronic obstructive pulmonary disease, smoking, current AF symptoms, and ablation.
