The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs
<strong>Background:</strong> Extended-release niacin with laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events in HPS2-THRIVE but its net effects on health and healthcare costs are unknown. <strong>Methods an...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
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American Heart Association
2016
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| _version_ | 1826289292107841536 |
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| author | Kent, S Haynes, R Hopewell, J Parish, S Gray, A Landray, M Collins, R Armitage, J Mihaylova, B |
| author_facet | Kent, S Haynes, R Hopewell, J Parish, S Gray, A Landray, M Collins, R Armitage, J Mihaylova, B |
| author_sort | Kent, S |
| collection | OXFORD |
| description | <strong>Background:</strong> Extended-release niacin with laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events in HPS2-THRIVE but its net effects on health and healthcare costs are unknown. <strong>Methods and Results:</strong> 25,673 participants aged 50 to 80 years with prior vascular disease were randomized to 2g of extended-release niacin with 40mg of laropiprant daily versus matching placebo, in addition to effective statin-based LDL cholesterol-lowering treatment. The net effects of niacin-laropiprant on quality of life-adjusted survival (QALYs) and hospital care costs (2012 GBP; converted into USD using purchasing power parity index) over 4 years in HPS2-THRIVE were evaluated using estimates of the impact of serious adverse events on health-related quality of life and hospital care costs. During the study, participants assigned niacin-laropiprant experienced marginally but not statistically significantly lower survival (0.012 fewer years [SE 0.007]), fewer quality-adjusted life years (0.023 [SE 0.007] less QALYs using UK EQ-5D scores; 0.020 [SE 0.006] less QALYs using US EQ-5D scores) and accrued greater hospital costs (GBP101 [SE £37]; USD145 [SE USD53]). Stroke, heart failure, musculoskeletal, gastrointestinal events, and infections were associated with significant decreases in health-related quality of life in both the year of the event and in subsequent years. All serious vascular and nonvascular events were associated with substantial increases in hospital care costs. <strong>Conclusions:</strong> In HPS2-THRIVE, the addition of extended-release niacin-laropiprant to statin- based therapy reduced quality of life-adjusted survival and increased hospital costs. |
| first_indexed | 2024-03-07T02:26:40Z |
| format | Journal article |
| id | oxford-uuid:a5d7691b-9ac0-4da0-9c42-72f528adf815 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T02:26:40Z |
| publishDate | 2016 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:a5d7691b-9ac0-4da0-9c42-72f528adf8152022-03-27T02:43:09ZThe effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a5d7691b-9ac0-4da0-9c42-72f528adf815Symplectic Elements at OxfordAmerican Heart Association2016Kent, SHaynes, RHopewell, JParish, SGray, ALandray, MCollins, RArmitage, JMihaylova, B<strong>Background:</strong> Extended-release niacin with laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events in HPS2-THRIVE but its net effects on health and healthcare costs are unknown. <strong>Methods and Results:</strong> 25,673 participants aged 50 to 80 years with prior vascular disease were randomized to 2g of extended-release niacin with 40mg of laropiprant daily versus matching placebo, in addition to effective statin-based LDL cholesterol-lowering treatment. The net effects of niacin-laropiprant on quality of life-adjusted survival (QALYs) and hospital care costs (2012 GBP; converted into USD using purchasing power parity index) over 4 years in HPS2-THRIVE were evaluated using estimates of the impact of serious adverse events on health-related quality of life and hospital care costs. During the study, participants assigned niacin-laropiprant experienced marginally but not statistically significantly lower survival (0.012 fewer years [SE 0.007]), fewer quality-adjusted life years (0.023 [SE 0.007] less QALYs using UK EQ-5D scores; 0.020 [SE 0.006] less QALYs using US EQ-5D scores) and accrued greater hospital costs (GBP101 [SE £37]; USD145 [SE USD53]). Stroke, heart failure, musculoskeletal, gastrointestinal events, and infections were associated with significant decreases in health-related quality of life in both the year of the event and in subsequent years. All serious vascular and nonvascular events were associated with substantial increases in hospital care costs. <strong>Conclusions:</strong> In HPS2-THRIVE, the addition of extended-release niacin-laropiprant to statin- based therapy reduced quality of life-adjusted survival and increased hospital costs. |
| spellingShingle | Kent, S Haynes, R Hopewell, J Parish, S Gray, A Landray, M Collins, R Armitage, J Mihaylova, B The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs |
| title | The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs |
| title_full | The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs |
| title_fullStr | The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs |
| title_full_unstemmed | The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs |
| title_short | The effects of vascular and nonvascular adverse events and of extended-release niacin with laropiprant on health and healthcare costs |
| title_sort | effects of vascular and nonvascular adverse events and of extended release niacin with laropiprant on health and healthcare costs |
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