Medical Affairs, MSD K.K, Kitanomaru Square, 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan.
Biostatistics and Research Decision Sciences, MSD K.K, Kitanomaru Square, 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan.
BMC Infect Dis. 2018 May 24;18(1):237. doi: 10.1186/s12879-018-3148-z.
Direct-acting anti-viral agents have improved the treatment of chronic hepatitis C virus (HCV) infection, but this treatment is challenging for patients using co-medications because of potential drug-drug interactions. This study aimed to examine the comorbidities and co-medications of Japanese chronic HCV patients by age group, compared with a non-HCV patient population.
This was a retrospective observational study using a hospital-based medical claims database. We extracted data of patients with chronic HCV aged ≥18 years, and age-, sex-, and hospital-matched patients without HCV, for the period from January 2015 to November 2016, and then examined chronic comorbidities, long-term co-medications, and medications prescribed at least once during the study period.
We analysed data from 128,967 chronic HCV patients and 515,868 non-HCV patients. The median age was 70 years, and 51.0% of patients were male. More chronic HCV patients than non-HCV patients (70.5% vs. 47.1%) had at least one comorbidity, and older patients had more comorbidities than younger patients. The most common comorbidities in chronic HCV patients were diseases of oesophagus, stomach and duodenum (41.7%), followed by hypertensive diseases (31.4%). Chronic HCV patients used co-medications more commonly than non-HCV patients, and older patients used more co-medications. The most common long-term co-medications in chronic HCV patients were proton pump inhibitors (14.0%), which were prescribed to 31.9% of chronic HCV patients at least once during the study period.
Patients with chronic HCV in Japan had more comorbidities than patients without chronic HCV regardless of age. Particularly older patients, who constitute the majority of the HCV patient population in Japan, commonly had multiple comorbidities and used co-medications. To optimise HCV treatment, physicians need to know the exact medication profiles of patients and take appropriate action to manage drug-drug interactions.
直接作用抗病毒药物改善了慢性丙型肝炎病毒(HCV)感染的治疗效果,但由于潜在的药物相互作用,对于同时使用合并药物治疗的患者来说,这种治疗具有挑战性。本研究旨在按年龄组比较日本慢性 HCV 患者与非 HCV 患者的合并症和合并用药情况。
这是一项使用基于医院的医疗索赔数据库的回顾性观察性研究。我们提取了 2015 年 1 月至 2016 年 11 月期间年龄≥18 岁的慢性 HCV 患者的数据,并按年龄、性别和医院匹配了没有 HCV 的患者数据,然后检查了慢性合并症、长期合并用药以及在研究期间至少使用过一次的药物。
我们分析了 128967 例慢性 HCV 患者和 515868 例非 HCV 患者的数据。中位年龄为 70 岁,51.0%的患者为男性。与非 HCV 患者相比,更多的慢性 HCV 患者(70.5%比 47.1%)有至少一种合并症,且年龄较大的患者合并症更多。慢性 HCV 患者最常见的合并症是食管、胃和十二指肠疾病(41.7%),其次是高血压疾病(31.4%)。慢性 HCV 患者比非 HCV 患者更常使用合并用药,且年龄较大的患者使用的合并用药更多。慢性 HCV 患者最常用的长期合并用药是质子泵抑制剂(14.0%),在研究期间至少有 31.9%的慢性 HCV 患者使用过。
无论年龄大小,日本的慢性 HCV 患者比非慢性 HCV 患者有更多的合并症。特别是在日本 HCV 患者人群中占多数的老年患者,通常有多种合并症并使用合并药物治疗。为了优化 HCV 治疗,医生需要了解患者的确切用药情况,并采取适当措施来管理药物相互作用。