Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.
Celgene Europe Limited, Uxbridge, UK.
J Neurol. 2019 May;266(5):1095-1106. doi: 10.1007/s00415-019-09238-8. Epub 2019 Feb 18.
To describe the resources and methods used to identify and validate multiple sclerosis (MS) and match non-MS patients in each of the two databases, and to characterize their demographics, comorbidities and concomitant medications.
This study was conducted in two separate electronic medical databases, the United States Department of Defense (DOD) military health care system and the United Kingdom's Clinical Practice Research Datalink (CPRD) GOLD. We identified patients with a first recorded diagnosis of MS in 2001-2016 (CPRD) or 2004-2017 (DOD) and matched non-MS patients using algorithms appropriate to each database. We describe patient symptoms, comorbidities, and medication use at the time of the MS diagnosis and compared them to the non-MS cohort.
We identified 8695 patients with MS and 86,934 matched non-MS patients in the DOD database and 6932 patients with MS and 68,526 matched non-MS patients in CPRD GOLD. Most MS patients were female (around 70%) and were diagnosed before age 60 (88%). MS patients had higher prevalence of depression and other psychiatric conditions at MS diagnosis compared to non-MS patients. Epilepsy, fractures and infections were also more common. MS patients had many expected symptoms and treatments documented in their records prior to the MS diagnosis.
These results are consistent between the two databases, as well as with previous studies of MS. Future analyses of these patients' experience after MS diagnosis will provide valuable insights into disease and treatment patterns in relation to risk of chronic diseases and mortality.
描述在两个数据库中识别和验证多发性硬化症(MS)并匹配非 MS 患者的资源和方法,并描述其人口统计学、合并症和伴随用药情况。
本研究在两个独立的电子医疗数据库中进行,即美国国防部(DOD)医疗保健系统和英国临床实践研究数据链接(CPRD)GOLD。我们在 2001-2016 年(CPRD)或 2004-2017 年(DOD)期间记录了首次诊断为 MS 的患者,并使用适合每个数据库的算法匹配非 MS 患者。我们描述了 MS 诊断时患者的症状、合并症和用药情况,并将其与非 MS 队列进行比较。
我们在 DOD 数据库中确定了 8695 例 MS 患者和 86934 例匹配的非 MS 患者,在 CPRD GOLD 中确定了 6932 例 MS 患者和 68526 例匹配的非 MS 患者。大多数 MS 患者为女性(约 70%),且在 60 岁之前被诊断出(88%)。与非 MS 患者相比,MS 患者在 MS 诊断时患有抑郁和其他精神疾病的比例更高。癫痫、骨折和感染也更为常见。在 MS 诊断之前,MS 患者的记录中已有许多预期的症状和治疗方法。
这些结果在两个数据库之间以及与之前的 MS 研究一致。对这些患者在 MS 诊断后的经历进行的进一步分析将为了解与慢性病和死亡率相关的疾病和治疗模式提供有价值的见解。