Evidence map›Paper›PMID 40131965›Full record

ArticlePloS one2025

Dosing patterns and dose effects of sacubitril/valsartan: A claims-based retrospective cohort study.

Jillian M Rung, Tyson S Barrett, Keith LeJeune, Shannon B Richards, Amresh Raina, Lawrence Sinoway

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jillian M RungEnterprise Analytics, Highmark Health, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0002-5945-6454
Tyson S BarrettEnterprise Analytics, Highmark Health, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0002-2137-1391
Keith LeJeuneEnterprise Analytics, Highmark Health, Pittsburgh, Pennsylvania, United States of America.
Shannon B RichardsEnterprise Analytics, Highmark Health, Pittsburgh, Pennsylvania, United States of America.
Amresh RainaAllegheny General Hospital, Pittsburgh, Pennsylvania, United States of America.
Lawrence SinowayPenn State Health, Hershey, Pennsylvania, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe goals of this retrospective cohort analysis were to determine real-world dose and titration patterns of sacubitril/valsartan (SAC/VAL), a heart failure medication, and examine whether dose patterns are associated with healthcare utilization and costs.

methodsAdult health plan members (18-100 years old) who initiated SAC/VAL between 2020 and 2022 and had continuous enrollment 6 months prior to, and at least 3 months following SAC/VAL initiation were identified. Members also had to have 3 months of SAC/VAL fills with good adherence (N =  2,977). Claims data were used to characterize dosage patterns and compare total costs of care, as well as all-cause and heart failure- hospital admissions across those with different terminal SAC/VAL doses.

resultsMost members initiated SAC/VAL at the lowest dose (76%, n =  2,267), of whom few titrated upward by their final fill (31%, n =  703). Overall, only 19% (n =  563) were at target by their final fill. Those ending on higher doses experienced significantly fewer all-cause admissions (incidence rate ratios of 1.52 [SE = .16] to 2.66 [SE = .37]; ps < .001) and incurred significantly lower total costs of care while on SAC/VAL (cost ratios of 1.21 [SE = .06] to 1.48 [SE = .09]; ps < .001).

conclusionMost individuals initiate and remain on the lowest SAC/VAL dose despite guidelines to titrate upward. SAC/VAL dosage is significantly associated with outcomes, with higher doses associated with more clinical and cost benefits. Research is needed to identify barriers to dose titration and to develop interventions for maximal patient benefit.

Indexed as

AminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsHeart FailureValsartanAdolescentAdultAgedAged, 80 and overDose-Response Relationship, DrugDrug CombinationsFemaleHospitalizationHumansMaleMiddle AgedAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug Combinationssacubitril and valsartan sodium hydrate drug combinationValsartan

Identifiers

PMID40131965
PMCPMC11936244

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.