Cardiovascular Burden of Patients Diagnosed With Idiopathic Hypersomnia: Real-World Idiopathic Hypersomnia Total Health Model (CV-RHYTHM)

This work was sponsored by Jazz Pharmaceuticals Introduction: This study compared the odds of cardiovascular (CV) conditions in patients with idiopathic hypersomnia (IH) versus matched non-IH controls. Methods: Merative™ MarketScan® administrative claims (12/2013-2/2020) were analyzed. Eligible patients were aged ≥18 years upon cohort entry, had 365 days of continuous enrollment (gaps ≤30 days allowed) before and after cohort entry, and were without cataplexy. IH cases entered the cohort upon their earliest medical claim containing an IH diagnosis code (ICD-9-CM, 327.11, 327.12; ICD-10-CM, G47.11, G47.12) in any position. Non-IH controls were matched 5:1 to patients with IH on age, sex, region, payer type, and cohort entry date. Unconditional logistic regression was used to compare odds of CV conditions during the 2-year period; model covariates were the same as those used for matching. Differences were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Final cohorts included 11,412 patients with IH and 57,058 non-IH controls. Odds (OR [95% CI]) of CV disease (2.26 [2.14-2.38]), major adverse CV event (2.08 [1.89-2.30]), stroke (2.07 [1.87-2.29]), hypertension diagnosis or antihypertensives use (2.02 [1.93-2.12]), heart failure (1.97 [1.76-2.20]), atrial fibrillation (1.91 [1.66-2.20]), myocardial infarction (1.74 [1.42-2.12]), coronary revascularization (1.58 [1.12-2.17]), and cardiac arrest (1.44 [0.91-2.20]) were higher in patients with IH compared with non-IH controls. Conclusion: Patients with IH have higher odds of CV conditions compared with non-IH controls, highlighting the importance of CV health in patients with IH. Because many therapies that treat IH symptoms carry CV risks, clinicians should prioritize therapies that treat IH symptoms without increasing CV risk.