Okayasu Motohiro, Ogata Haruhiko, Yoshiyama Yuji
Laboratory of Community Pharmacy, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, School of Pharmacy, Kitasato University, Tokyo, Japan.
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.
J Mark Access Health Policy. 2019 Jan 22;7(1):1565889. doi: 10.1080/20016689.2019.1565889. eCollection 2019.
: Corticosteroids may be temporarily effective for ulcerative colitis (UC), but long-term use increases the risk of adverse drug reactions. : The goal of the study was to examine steroid use in remission induction therapy after diagnosis of UC. : A retrospective observational study using the Japan Medical Data Center (JMDC) Claims Database from January 2008 to December 2014. : Clinics, university hospitals, and national/public hospitals. : Initiation of steroids after diagnosis of UC. : Start time and annual rate of steroid use, and use during the first 6 months of remission induction therapy. : The subjects were 399 patients were newly diagnosed with UC in the study period. The rate of steroid use after diagnosis was 58.4% in 2009, and showed a significant decreasing trend yearly after 2010 (p ≤ 0.0001). Regarding the start time, 52.2% of patients began steroids within 60 days after diagnosis of UC. At 6 months after initiation, 23.7% continued to use steroids and 73.9% of these patients used high-dose steroids. : In treatment of UC after diagnosis, many patients continue to use steroids for >6 months after initiation. Reduced use of steroids based on clinical practice guidelines for UC should be promoted.
皮质类固醇可能对溃疡性结肠炎（UC）有短期疗效，但长期使用会增加药物不良反应的风险。本研究的目的是调查UC诊断后缓解诱导治疗中类固醇的使用情况。一项回顾性观察研究，使用了日本医疗数据中心（JMDC）2008年1月至2014年12月的索赔数据库。研究机构包括诊所、大学医院和国家/公立医院。观察UC诊断后开始使用类固醇的情况。类固醇使用的开始时间和年使用率，以及缓解诱导治疗前6个月的使用情况。研究期间有399例新诊断为UC的患者。2009年诊断后类固醇的使用率为58.4%，2010年后呈显著下降趋势（p≤0.0001）。关于开始时间，52.2%的患者在UC诊断后60天内开始使用类固醇。开始使用类固醇6个月后，23.7%的患者继续使用，其中73.9%的患者使用高剂量类固醇。在UC诊断后的治疗中，许多患者在开始使用类固醇后持续使用超过6个月。应根据UC临床实践指南促进减少类固醇的使用。
