Abstract
Eplerenone, a mineralocorticoid receptor antagonist (MRA), is available in Japan, but details of its use in clinical settings have not been thoroughly investigated. Thus, this study was aimed at examining the characteristics of eplerenone-prescribed hypertensive patients in Japan, describing the combination patterns of antihypertensive medications, and comparing eplerenone's mean doses with respect to concomitant diseases. Data of 160,992 hypertensive patients who used the same drugs for six months or more were collected from an insurance database from January 1, 2009, to December 31, 2013. The number of MRA-receiving patients among the extracted population was 3,274 (2%). Compared to patients on eplerenone or spironolactone, patients on neither drug had fewer comorbidities. Eplerenone was administered in combination with calcium channel blockers and angiotensin II receptor blockers in 23.1% and as monotherapy in 6.6% of cases. The most frequent initial daily dose of eplerenone was 50 mg/day followed by 25 mg/day irrespective of the presence of a comorbidity. MRA use was as low as 2%, but its use was more frequent in patients with comorbidities compared to that of other antihypertensives. Despite studies showing eplerenone's efficacy and safety in high-risk hypertensive patients with albuminuria, the drug is not widely used.
Highlights
Drug treatment options for arterial hypertension have increased and some of them have organ-protective effects [1,2,3]
The results of postmarketing surveillance of eplerenone in Japan were published [4]; the surveillance provided information on the safety and efficacy of the drug in real-world settings. It did not provide detailed information on different dosages as related to patient backgrounds such as the presence of concomitant diseases including heart failure or renal disease
Information about antihypertensive drug use including that of mineralocorticoid receptor antagonist (MRA), especially eplerenone, would serve as a useful reference for Japanese physicians as well as those in other countries to understand how these drugs are currently used and how their use should be improved
Summary
Drug treatment options for arterial hypertension have increased and some of them have organ-protective effects [1,2,3]. The results of postmarketing surveillance of eplerenone in Japan were published [4]; the surveillance provided information on the safety and efficacy of the drug in real-world settings. It did not provide detailed information on different dosages as related to patient backgrounds such as the presence of concomitant diseases including heart failure or renal disease. The objectives of this study were to (1) investigate the characteristics of hypertensive patients prescribed eplerenone or spironolactone and compare them against those of patients who did not use either drug, (2) describe the combination patterns of antihypertensive medications among patients prescribed eplerenone, spironolactone, or neither drug, and (3) compare mean doses of eplerenone with respect to concomitant diseases (cardiovascular diseases, diabetes mellitus, heart failure, and renal dysfunction)
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