Characterizing real-world use of vericiguat in the United States.

Background: Contemporary data regarding uptake of vericiguat for treatment of heart failure (HF), including achievement of target dose (10 mg), are lacking.

Methods: A retrospective analysis of TriNetX claims data was conducted. The study included US adults with HF receiving vericiguat from January 20, 2021, to November 20, 2023. Baseline patient characteristics, health care resource use, and follow-up vericiguat titration were described. Multivariable logistic regression models identified factors associated with reaching the vericiguat target dose.

Results: The study sample included 5149 patients (mean age 68 years, 67% male, 55% White). Common comorbidities included hypertension (89%) and hyperlipidemia (81%). Over a 12-month baseline, 35%, 44%, and 38% of patients experienced worsening HF events, all-cause hospitalizations, and emergency department visits, respectively. Common guideline-directed medical therapy (GDMT) classes received at baseline included beta-blockers (74%), angiotensin receptor neprilysin inhibitors (ARNi; 52%), sodium glucose cotransporter-2 inhibitors (SGLT2i; 44%), and mineralocorticoid receptor antagonists (MRAs; 40%). Approximately 36% of patients reached the vericiguat target dose over a median (interquartile range) follow-up of 433 (247-606) days. Factors associated with reaching the target dose included age, baseline medication with MRAs, beta-blockers, or combination therapy with ARNi and SGLT2i, and the Charlson Comorbidity Index score.

Conclusion: Approximately one-third of patients treated with vericiguat reached the 10-mg target dose during follow-up, with receipt of a beta blocker, MRA, or ARNi + SGLT2i combination at baseline associated with achievement of the target dose. These data inform contemporary use of novel GDMT and may support quality improvement efforts to enhance the effective implementation of GDMT in appropriate patients.