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利用疾病修正治疗处方数据观察 2010-2017 年澳大利亚多发性硬化症患病率的变化。

Change in multiple sclerosis prevalence over time in Australia 2010-2017 utilising disease-modifying therapy prescription data.

机构信息

Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.

Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia.

出版信息

Mult Scler. 2020 Oct;26(11):1315-1328. doi: 10.1177/1352458519861270. Epub 2019 Jul 26.

Abstract

OBJECTIVE

Determine the prevalence of multiple sclerosis (MS) in Australia in 2017 using MS-specific disease-modifying therapy (DMT) prescription data and estimate the change in prevalence from 2010.

METHODS

DMT prescriptions were extracted from Australia's Pharmaceutical Benefits Scheme (PBS) data for January-December 2017. Percentages of people with MS using DMTs (DMT penetrance) were calculated using data from the Australian MS Longitudinal Study. Prevalence was estimated by dividing the total number of monthly prescriptions by 12 (except alemtuzumab), adjusted for DMT penetrance and Australian population estimates. Prevalences in Australian states/territories were age-standardised to the Australian population. Comparisons with 2010 prevalence data were performed using Poisson regression.

RESULTS

Overall DMT penetrance was 64%, and the number of people with MS in Australia in 2017 was 25,607 (95% confidence interval (CI): 24,874-26,478), a significant increase of 4324 people since 2010 ( < 0.001). The prevalence increased significantly from 95.6/100,000 (2010) to 103.7/100,000 (2017), with estimates highest in Tasmania in 2017 (138.7/100,000; 95% CI: 137.2-140.1) and lowest in Queensland (74.6/100,000; 95% CI: 73.5-75.6). From 2010 to 2017 using the median latitudes for each state/territory, the overall latitudinal variation in MS prevalence was an increase of 3.0% per degree-latitude.

CONCLUSION

Consistent with global trends, Australia's MS prevalence has increased; this probably reflecting decreased mortality, increased longevity and increased incidence.

摘要

目的

利用多发性硬化症(MS)特异性疾病修正治疗(DMT)处方数据,确定 2017 年澳大利亚 MS 的患病率,并估计 2010 年以来患病率的变化。

方法

从澳大利亚药品福利计划(PBS)2017 年 1 月至 12 月的数据中提取 DMT 处方。使用澳大利亚多发性硬化症纵向研究的数据计算使用 DMT 的 MS 患者比例(DMT 渗透率)。患病率通过将每月总处方数除以 12(除外阿仑单抗)来估计,同时考虑 DMT 渗透率和澳大利亚人口估计数进行调整。对澳大利亚各州/领地的患病率进行年龄标准化,使其与澳大利亚人口相匹配。使用泊松回归比较 2010 年的患病率数据。

结果

总体 DMT 渗透率为 64%,2017 年澳大利亚 MS 患者人数为 25607 人(95%置信区间(CI):24874-26478),与 2010 年相比增加了 4324 人( < 0.001)。患病率从 2010 年的 95.6/100000 显著增加到 2017 年的 103.7/100000( < 0.001),2017 年塔斯马尼亚州的患病率最高(138.7/100000;95%CI:137.2-140.1),昆士兰州的患病率最低(74.6/100000;95%CI:73.5-75.6)。根据各州/领地的中纬度中位数,从 2010 年到 2017 年,MS 患病率的整体纬度变化为每度纬度增加 3.0%。

结论

与全球趋势一致,澳大利亚 MS 的患病率有所增加;这可能反映出死亡率降低、寿命延长和发病率增加。

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