Pharmacoepidemiology of statins and oral anticoagulants

​Description of Research

Finland with its comprehensive registers on drug prescriptions and hospital discharge diagnoses offers an excellent possibility for registry-based pharmacoepidemiology research which can be used to advance rational pharmacotherapy.

Statins are used in patients with dyslipidemia to reduce the risk of cardiovascular complications. We have studied especially the association of adherence to statins on therapeutic outcomes, such as myocardial infarctions and cerebrovascular complications, and on the cost-effectiveness of statin treatment in everyday clinical practice. Factors predicting poor compliance during maintenance therapy or channeling statin use to certain patient groups have been approached in order to improve targeting of drug therapy and to reduce noncompliance.

Lately drug interactions with warfarin, an oral anticoagulant used especially by subjects with atrial fibrillation, have been studied using the national data bases. Warfarin has a narrow therapeutic window and the goal is to characterize the frequency and timing of drug interactions at the population level. Information on warfarin use will be combined with outcome data, and the analysis later supplemented with information on the novel non-vitamin K-dependent oral anticoagulants. In parallel to clinical questions methodological development is carried out.

Members of the research group

Maarit Jaana Korhonen, PhD (Epid.)
Emma Aarnio, MSc (Pharm.)
Heli Halava, MD
Milka Hauta-aho, BM
Arja Helin-Salmivaara, MD, PhD
Piia Lavikainen, MSc (Stat.)
Pekka Tiittanen, MSc (Stat.)
Eveliina Upmeier, MD

Selected Publications

Helin-Salmivaara A, Lavikainen P, Aarnio E, Huupponen R, Korhonen MJ. Sequential cohort design applying propensity score matching to analyze the comparative effectiveness of atorvastatin and simvastatin in preventing cardiovascular events. PLoS ONE 9:e90325, 2014. doi:10.1371/journal.pone.0090325

Rikala M, Hauta-aho M, Helin-Salmivaara A, Lassila R, Korhonen MJ, Huupponen R: Co-prescribing of potentially interacting drugs during warfarin therapy – a population-based register study. Basic & Clinical Pharmacology & Toxicology 117: 126-132, 2015.

Aarnio E, Korhonen MJ, Huupponen R, Martikainen J. Cost-effectiveness of statin treatment for pri-mary prevention in conditions of real-world adherence – estimates from the Finnish prescription register. Atherosclerosis 239: 240-247, 2015.

Ilomäki J, Helin-Salmivaara A, Huupponen R, Rikala M, Kirkpatrick C, Korhonen MJ. Analgesic use before and after oral anticoagulant initiation – a population-based study in Finland. European Journal of Clinical Pharmacology 71: 723-732, 2015.

Rannanheimo P, Tiittanen P, Hartikainen J, Helin-Salmivaara A, Huupponen R, Vahtera J, Korhonen MJ. Impact of statin adherence on cardiovascular morbidity and all-cause mortality in the primary prevention of cardiovascular disease – a population-based cohort study in Finland. Value in Health 18: 896-905, 2015.

Publications of the Stateam project and their summaries