Department of Orthopedics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Orthopedics, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, South Korea.
PLoS One. 2020 Oct 6;15(10):e0240155. doi: 10.1371/journal.pone.0240155. eCollection 2020.
No studies of the current status of treatment options are available for ankylosing spondylitis (AS) patients in South Korea. This study assesses the current status of AS treatment trends using a nationwide database. This study was conducted using a Korean National Health Insurance System (KNHIS) dataset from 2006 to 2016. We randomly extracted 50% of the total number of patients registered as As patients in the KNHIS. The distribution of the number of patients according to age and gender was analyzed each year. The types and combination methods of drugs used during the study period were estimated yearly. Between 2006 and 2016, the number of AS patients increased linearly by an average of 9% annually, 6372 in 2006 to 15188 in 2016. The study found that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) was the most commonly prescribed pharmacological treatment option, followed by disease-modifying anti-rheumatic drugs (DMARDs) and then biologics. Biologics such as tumor necrosis factor alpha (TNF-α) inhibitors increased from 10% to 35% consistently for 10 years. In terms of combination therapy, DMARDs + NSAIDs accounted for almost 90% of treatments in 2006, but decreased by 65% in 2016. The use of biologics and NSAIDs increased from 3% to 28%. Prescriptions for dual therapies and mono therapies largely dominated prescription habits, accounted for up to approximately 80% of treatments. Among 10- to 14-year-old patients, there was no triple therapy, dual and triple therapies decreased gradually for those 60 and older, and the ratio of conservative treatments has increased. This study shows how South Korea reflects changes in AS treatment trends, along with the emergence of TNF-α inhibitors that are effective in treating AS. Research on clinical outcomes for AS treatments will be needed on following these drug changes.
目前，韩国尚无针对强直性脊柱炎（AS）患者治疗选择现状的研究。本研究使用全国健康保险系统（KNHIS）数据库评估 AS 治疗趋势的现状。本研究使用了 2006 年至 2016 年期间的韩国国家健康保险系统（KNHIS）数据集。我们随机抽取了 KNHIS 中登记的 AS 患者总数的 50%作为样本。每年分析患者的年龄和性别分布。每年估计研究期间使用的药物类型和组合方法。2006 年至 2016 年间，AS 患者的数量以每年平均 9%的速度线性增加，2006 年为 6372 人，2016 年为 15188 人。研究发现，非甾体抗炎药（NSAIDs）的使用是最常见的处方药物治疗选择，其次是疾病修饰抗风湿药物（DMARDs），然后是生物制剂。肿瘤坏死因子-α（TNF-α）抑制剂等生物制剂在 10 年内从 10%持续增加到 35%。在联合治疗方面，2006 年 DMARDs+NSAIDs 占治疗方法的近 90%，但 2016 年下降了 65%。生物制剂和 NSAIDs 的使用从 3%增加到 28%。双药和单药治疗的处方在很大程度上主导了治疗习惯，占治疗方法的 80%左右。在 10-14 岁的患者中，没有三联治疗，60 岁以上的患者双联和三联治疗逐渐减少，保守治疗的比例增加。本研究展示了韩国如何反映 AS 治疗趋势的变化，以及 TNF-α 抑制剂在治疗 AS 方面的有效性。随着这些药物的变化，需要对 AS 治疗的临床结果进行研究。
