Cardiovascular Clinical Trialists (CVCT) Forum – Paris 2012 : Is it always safe to believe in class effect: Spironolactone vs. eplerenone differences and clinical relevance?

Title : Cardiovascular Clinical Trialists (CVCT) Forum – Paris 2012 : Is it always safe to believe in class effect: Spironolactone vs. eplerenone differences and clinical relevance?Speaker: Bertram PITT, Ann Arbor, USAAbstract : Is it always safe to believe in class effect: Spironolactone vs. eplerenone differences and clinical relevance?L’auteur n’a pas transmis de conflit d’intérêt concernant les données diffusées dans cette vidéo ou publiées dans la référence citée.9th Global Cardiovascular Clinical Trialists Forum • Paris 2012 Multidisciplinary expert workshop : achievements challenges and barriers to implantation of the ESC 2012 chronic heart failure guidelines.Chairpersons: Alain COHEN-SOLAL, Paris, FRA - Adrian VOORS, Groningen, NEDBackground: The ESC-HFA chronic and acute heart failure guidelines have recently been published. However, the challenge for guidelines does not cease with a consensus document. Practical implementation is the critical step in establishing higher standards of care for individual patients. Improved guideline uptake is not only an index of better standards but a validation of the process of guideline production.Improving consensus between guidelines is also important, differences in recommendations may act as a barrier to guideline. The NICE CHF guidance was updated in 2010, and it is not likely to be revised in short term.Practice differs from the guideline recommendations. Registries suggest differences in guideline interpretation and treatment/management of CHF between different stakeholders. Similarities and differences exist between GPs and hospital physicians’ approaches to management of CHF. One important issue that is not covered by the current guidelines is the class effect issue. Canadian and Australian CHF guideline and 2010 NICE guideline name eplerenone as preferred drug in heart failure, ESC mentions only mineralocorticoid receptor antagonists (MRAs.) as a class.How to interpret compound vs. class effects while following guideline recommendations is an important issue.Cost-effectiveness is a key not only to the content of guidelines but also in the assessment of implementation. Limits on healthcare resources mandate that resource-allocation decisions be guided by considerations of cost in relation to expected benefits. In cost-effectiveness analysis, the ratio of net healthcare costs to net health benefits provides an index by which priorities may be set.Aims: This multidisciplinary consensus workshop aims at discussing CHF guideline implementation issues and the consequences on defining the place of MRA/eplerenone in management of CHF.Réalisation, production : Canal U/3S et CERIMESKeyword : Cardiovascular Clinical Trialists, Paris, 2012, Cardiovascular prevention, ESC-HFA, eplerenone