# Meer SGLT2-remmers en ARNI in hartfalen na 2021-richtlijn — claimsdatabase

*geplaatst 2026-09-11 · Hartfalen · International journal of clinical pharmacology and therapeutics · doi 10.5414/CP205008 · https://hartvaat.nl/2026/09/03/meer-sglt2-remmers-en-arni-in-hartfalen-na-2021-richtlijn-claimsdatabase/*

Een retrospectieve analyse van een Japanse verzekeringsclaimsdatabase toont aan dat de implementatie van de 2021-richtlijn voor hartfalen gepaard ging met een toename in het gebruik van richtlijnconforme medicatie (GDMT). Het percentage patiënten met een hoge GDMT-score steeg van 6,97% naar 9,33%, met name door een sterke stijging van het voorschrijfgewicht van sacubitril/valsartan (van 1,4% naar 22,6%) en dapagliflozine (van 12,4% naar 26,6%). Hoewel deze real-world data aangeeft dat nieuwe richtlijnen de farmacotherapie in de praktijk beïnvloeden, blijven lange-termijnonderzoeken nodig om de aanhoudende trend en klinische uitkomsten te bevestigen.

## English: Pharmacotherapy of heart failure: Impact of the 2021 guideline update on guideline-directed medical therapy assessed using a Japanese employee health insurance claims database.

A retrospective analysis of a Japanese health insurance claims database evaluated the impact of the 2021 heart failure guideline update on guideline-directed medical therapy (GDMT) utilization. Following the update, the proportion of patients achieving a high GDMT score increased from 6.97% to 9.33%, driven primarily by a substantial rise in prescriptions of sacubitril/valsartan (1.4% to 22.6%) and dapagliflozin (12.4% to 26.6%). While these real-world findings suggest that updated guidelines are translating into higher GDMT intensity in clinical practice, the data are limited to 2021 and require long-term follow-up to confirm sustained trends and clinical outcomes.

## Abstract (original, from the publication)

OBJECTIVE: To investigate the impact of the 2021 guideline update on guideline-directed medical therapy (GDMT) utilization in patients with heart failure (HF). BACKGROUND: The 2021 update of the Japanese guidelines for HF management followed the introduction of sacubitril/valsartan and dapagliflozin into clinical practice. However, the impact of this guideline update on drug utilization patterns remains unclear. MATERIALS AND METHODS: Patient data were obtained from the Japanese employee health insurance claims database (JMDC). The simple GDMT score was determined based on the combination and dose of four key pharmacological classes: β-blockers, renin-angiotensin system inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors. Because a simple GDMT score of ≥ 5 has been associated with improved prognosis in patients with HF, patients with scores ≥ 5 were classified into the high-score group for analysis. RESULTS: Following the guideline update, the proportion of patients in the high-score group increased from 6.97% (n = 4,013) to 9.33% (n = 6,363), standardized difference 0.09. The mean simple GDMT score also showed a small but statistically significant increase (5.72 ± 0.79 vs. 6.00 ± 1.09) with standardized difference 0.28. This upward trend was particularly marked for the prescription rates of sacubitril/valsartan and dapagliflozin (sacubitril/valsartan: 1.40% before the update vs. 22.57% after the update; standardized difference, 0.69; dapagliflozin: 12.41% before the update vs. 26.64% after the update; standardized difference, 0.36). CONCLUSION: The 2021 guideline update was associated with increased use of sacubitril/valsartan and dapagliflozin, resulting in greater overall GDMT intensity. However, these findings are limited to data from 2021, and further long-term studies are needed to evaluate trends in GDMT utilization.

Auteurs: Takaya Uno, Kouichi Hosomi, Satoshi Yokoyama

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Bron: International journal of clinical pharmacology and therapeutics, https://doi.org/10.5414/CP205008. Bijgewerkt 2026-09-04T01:11:15Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.