Kidney Week

Abstract: FR-PO1124

Beta-Blocker Prescriptions in Nondialysis-Dependent Patients with CKD: The French CKD-REIN Study

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Costes-Albrespic, Margaux, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Margaux Costes-Albrespic, MPH

• Liabeuf, Sophie, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, Hauts-de-France, France

Sophie Liabeuf, PharmD, PhD

• Laville, Solene M., Centre Hospitalier Universitaire Amiens-Picardie, Amiens, Hauts-de-France, France

Solene M. Laville, PharmD, PhD

• Lambert, Oriane, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Oriane Lambert, MPH

• Massy, Ziad, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, France

Ziad Massy, MD, PhD

• Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Natalia Alencar de Pinho, PhD

Background

Beta-blockers (BB) are a heterogeneous drug class often prescribed to patients with moderate to severe CKD. We aimed at describing real-world BB prescription patterns in these patients.

Methods

We analyzed 2,996 patients with CKD stages 2–5 under nephrology care from the CKD-REIN cohort study. BB prescriptions from any medical doctor were collected by clinical research associates based on anatomical therapeutic chemical (ATC) codes, as were patients’ demographic, clinical, and laboratory characteristics. Adverse drug reactions occurring during follow-up were adjudicated by a team of pharmacologists.

Results

Compared with patients with no BB prescription (n=1733, 58%), patients on BB (n=1263, 42%) were older (median age 68 vs. 70 years, respectively), had a higher mean systolic BP (143 vs 140 mm Hg), lower mean heart rate (68 vs 74 bpm), and more comorbidities including diabetes (53% vs 36%), coronary disease (CD, 39% vs 14%), heart failure (HF, 21% vs 7%) and atrial fibrillation (AF, 17% vs 8%). Fourteen different BB agents were prescribed, mostly cardioselective (94%), lipophilic (78%), and non-vasodilatory (71%). Bisoprolol (572, 45.3%), nebivolol (296, 23.5%) and atenolol (179, 14.2%) were the most common agents. Bisoprolol was more often prescribed to patients with history of HF, CD or AF than to patients with no CV history (32.5% vs 56.5%). In contrast, nebivolol exhibited a different pattern, with fewer prescriptions in patients with CV history compared to those without (17.6% vs. 30%). Over the 5 years of follow-up, the rate of adverse drugs reactions attributed to BBs was 7.5 per 1000 person-years (PY), notably bradycardia (4.1 per 1000 PY).

Conclusion

In pre-dialysis CKD patients, BB seems to be well-tolerated and commonly prescribed to high risk CV patients, with a preference for prescribing bisoprolol, nebivolol and atenolol.

Funding

• Commercial Support – Fresenius Medical Care and GlaxoSmithKline (GSK) since 2012 and Vifor France since 2018, Sanofi-Genzyme from 2012 to 2015, Baxter and Merck Sharp & Dohme-Chibret (MSD France) from 2012 to 2017, Amgen from 2012 to 2020, Lilly France from 2013 to 2018, Otsuka Pharmaceutical from 2015 to 2020, AstraZeneca from 2018 to 2021 and Boehringer Ingelheim France since 2022.