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...

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Główni autorzy: Kent, S, Haynes, R, Hopewell, J, Parish, S, Gray, A, Landray, M, Collins, R, Armitage, J, Mihaylova, B
Format: Journal article
Wydane: American Heart Association 2016
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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.
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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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