Medicines Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan.
Department of Healthcare Economics and Health Policy, University of Tokyo, Tokyo, Japan.
Pain Med. 2021 Dec 11;22(12):3041-3050. doi: 10.1093/pm/pnaa424.
Assess long-term comorbidity burden and pain management patterns among working-age patients with knee osteoarthritis (KOA) only without low back pain (LBP) (KOA-noLBP) and patients with KOA plus LBP (KOA+LBP) in Japan.
Retrospective claims data analyses were conducted on data from the Japan Medical Data Center (JMDC) database. Adult patients (≥40 years) with a diagnosis of knee osteoarthritis (KOA) (January 1, 2011-December 31, 2012) and 5 years of follow-up were evaluated. The first claim with a KOA diagnosis defined the index date. Longitudinal pain management patterns were assessed in both cohorts.
Overall, 1,828 patients met study criteria (717 with KOA-noLBP; 1,111 with KOA+LBP). The mean age of patients with KOA-noLBP was 52.1 years, and that of patients with KOA+LBP was 53.1 years, with more females in the KOA+LBP cohort (49.4% vs. 55.0%). Regardless of cohort, >90% of patients received pharmacological intervention during the 5-year follow-up period. The most common regimen first received was either topical or oral nonsteroidal anti-inflammatory drugs. A higher mean number of pharmaceutical treatments were received by patients in the KOA+LBP cohort (3.6) than by patients in the KOA-noLBP cohort (2.7) during the follow-up period. Regardless of cohort, most of the direct medical cost was derived from medication.
This study demonstrates that a greater proportion of the JMDC population of working individuals with KOA were comorbid with LBP and received pain-related treatment in the long-term perspective relative to patients with KOA without LBP. Appropriate pain management for both KOA and LBP would be key for effective resource utilization in an aging society facing socioeconomic burdens.
评估仅患有膝骨关节炎(KOA)而无下腰痛(LBP)的日本工作年龄患者(KOA-noLBP)和同时患有 KOA 和 LBP 的患者(KOA+LBP)的长期合并症负担和疼痛管理模式。
对来自日本医疗数据中心(JMDC)数据库的回顾性索赔数据进行分析。评估 2011 年 1 月 1 日至 2012 年 12 月 31 日期间患有膝骨关节炎(KOA)(≥40 岁)并随访 5 年的成年患者。首次 KOA 诊断的索赔定义为索引日期。对两个队列的纵向疼痛管理模式进行评估。
总体而言,1828 名患者符合研究标准(717 名 KOA-noLBP;1111 名 KOA+LBP)。KOA-noLBP 患者的平均年龄为 52.1 岁,KOA+LBP 患者的平均年龄为 53.1 岁,KOA+LBP 队列中女性比例更高(49.4% vs. 55.0%)。无论队列如何,在 5 年的随访期间,超过 90%的患者接受了药物干预。接受的最常见治疗方案是局部或口服非甾体抗炎药。在随访期间,KOA+LBP 队列的患者接受的药物治疗方案数量平均多于 KOA-noLBP 队列(3.6 比 2.7)。无论队列如何,大部分直接医疗费用都来自药物治疗。
本研究表明,与无 LBP 的 KOA 患者相比,JMDC 工作人群中患有 KOA 的患者中有更大比例合并 LBP,并从长期角度接受了与疼痛相关的治疗。对于面临社会经济负担的老龄化社会,适当治疗 KOA 和 LBP 将是有效利用资源的关键。