Colesevelam in the treatment of hypercholesterolemia and hyperglycemia: a retrospective analysis from an ambulatory care medical network

Abstract

Objective:

To examine outcomes associated with colesevelam treatment among patients with hypercholesterolemia in real-world clinical practice.

Methods:

This analysis was conducted as a retrospective, observational cohort study in an ambulatory-care medical network in Northern California. Patients with orders for colesevelam were identified in the electronic health record between January 2004 and December 2011. The date of the first order during the study period was designated the index date. Patients were evaluated for the following eligibility criteria: a diagnosis of hypercholesterolemia, ≥18 years of age at index date, baseline laboratory values ≤3 months before the index date, ≥12 months of treatment and follow-up, and no prior orders for colesevelam ≤12 months before the index date. Patients who were pregnant during the study period were excluded. Changes in LDL-C and percentage of patients at LDL-C goal were examined. Among patients with diabetes mellitus (DM), changes in glycated hemoglobin (HBA1C) and percentage of patients at HBA1C goal were also examined.

Results:

Overall, 468 and 181 patients with hypercholesterolemia met the predefined inclusion criteria with treatment and follow-up through 12 and 24 months, respectively. LDL-C decreased significantly from baseline by a mean of 11.4 mg/dL and 15.7 mg/dL (P < 0.0001, for each) at 12 and 24 months, respectively, and the percentages of patients at LDL-C goal increased by 13.9% and 21.0%. Among patients with DM and a baseline HBA1C ≥8%, 113 and 39 had treatment and follow-up through 12 and 24 months, respectively. HBA1C decreased significantly by a mean of 0.72% (P = 0.0001) and 0.75% (P = 0.010) and 11.5% and 12.8% were at HBA1C goal at 12 and 24 months, respectively. This study is limited by its retrospective and observational study design.

Conclusions:

Colesevelam treatment in a real-world setting was associated with improvements in LDL-C and HBA1C through 24 months of follow-up.

Keywords::

• Bile acid sequestrant
• Colesevelam
• Hypercholesterolemia
• Hyperglycemia

Transparency

Declaration of funding

This study was funded by Daiichi Sankyo Inc. Editorial support for the preparation of the manuscript was funded by Daiichi Sankyo Inc. and provided by MedMentis Consulting.

Declaration of financial/other relationships

X.Y. is an employee of Daiichi Sankyo Inc. C.Q. is an employee of Daiichi Sankyo Inc. and owns stock in the company. R.J.R., A.L., T.J. and D.Y.I. have received research funding from Daiichi Sankyo Inc.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The authors thank Dennis Honda PharmD and Amiee Kang MPH of Daiichi Sankyo for their comments in the conduct of the study and the development of this manuscript. The also thank Jen Wogen of MedMentis Consulting for editorial support in the preparation of this manuscript.

Previous presentation: The results of this study were presented, in part, at the 15th Annual European Congress of the International Society for Pharmacoeconomics and Outcomes Research, Berlin, Germany, 3–7 November 2012.