Cardiology and Therapy · Published 2025-10-11 · DOI 10.1007/s40119-025-00431-7
Abstract Introduction Obstructive hypertrophic cardiomyopathy (HCM) increases the risk of developing cardiac complications and can impact long-term outcomes, necessitating appropriate treatment. However, real-world data on how patients with obstructive HCM are currently managed, especially in Japan, remain limited. This study evaluated pharmacological treatment patterns, incidence of nonpharmacological interventions, and healthcare resource utilization (HCRU) associated with obstructive HCM management in Japan. Methods This retrospective longitudinal study analyzed claims data (N = 12,503,399) provided by insurers between April 1, 2014, and December 31, 2022. The primary objective was to describe the treatment pattern of patients with obstructive HCM. Any medication changes (beta-blockers [BBs], non-dihydropyridine [DHP] calcium channel blockers [CCBs], and sodium channel blockers [SCBs]), incidence of nonpharmacological interventions, and HCRU were assessed. Results Among 403 eligible patients, 72.5% were female, with a mean ± standard deviation age of 75.5 ± 11.7 years. The most common index medication was BB only (74.19%), followed by BB + SCB (10.42%), SCB (8.93%), BB + CCB (1.99%), CCB (3.72%), BB + CCB + SCB (0.5%), and CCB + SCB (0.25%). Overall, 123 (30.5%) patients experienced a treatment change within 12 months after the first prescription, of whom 5 (1.2%) switched to a different medication, 51 (12.7%) had an add-on to the index medication, and 67 (16.6%) discontinued their treatment. SCB was prescribed as initial treatment to 20.1% of patients. The discontinuation rate at 12 months was the highest for SCB (22%), followed by BB (16%) and CCB (12%). Dose reduction was the highest for SCB (22.2%), followed by BB (12%) and CCB (4%). The rate of nonpharmacological interventions (events/100 person-years) was similar for pacemaker implantation and septal ablation (2.0), followed by implantable cardioverter-defibrillators (1.2) and mitral valve replacement (1.1). Conclusions These findings will guide future research aimed at optimizing obstructive HCM management.
Abstract from DOAJ. Public domain (CC0 1.0).
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