Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Division of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.
Ann Hepatol. 2022 Jul-Aug;27(4):100699. doi: 10.1016/j.aohep.2022.100699. Epub 2022 Mar 9.
Clinical guidelines recommend specific drugs for type 2 diabetes (T2D), hypertension, and dyslipidemia in patients with non-alcoholic fatty liver disease (NAFLD) and/or non-alcoholic steatohepatitis (NASH). We aimed to investigate the differences in prescription trends of antidiabetic, antihypertensive, and lipid-lowering drugs among adult patients according to the presence of comorbid NAFLD and/or NASH.
We conducted a cross-sectional analysis using a large claims database from January 2013 to December 2020.
Among 7,716,908 people, 47,157 patients with T2D, 180,050 with hypertension, and 191,348 with dyslipidemia were identified. A total of 8,897, 16,451, and 24,762 patients with NAFLD, as well as 435, 523, and 1033 patients with NASH, had T2D, hypertension, and dyslipidemia, respectively. Among antidiabetic drugs, sodium-glucose cotransporter-2 inhibitors (SGLT2is) and thiazolidine were more frequently prescribed to patients with NAFLD than to those without NAFLD (non-NAFLD) (thiazolidine: 1.4% and 2.8% and SGLT2is: 17.8% and 25.9% for non-NAFLD and NAFLD, respectively [2019-2020]). Among antihypertensive drugs, angiotensin II receptor antagonists exhibited a slightly higher prescription ratio in patients with NAFLD (33.6% vs. 39.0%). Regarding lipid-lowering drugs, fibrates were more frequently prescribed to patients with NAFLD (10.3% vs. 18.4%).
Specific drugs tended to be prescribed to patients with NAFLD. However, the differences in prescription ratios were not considerable. Further investigation is required to confirm the effects of drugs on the prognosis of patients with NAFLD or NASH.
临床指南推荐特定药物用于非酒精性脂肪性肝病（NAFLD）和/或非酒精性脂肪性肝炎（NASH）伴 2 型糖尿病（T2D）、高血压和血脂异常的患者。我们旨在研究根据合并存在 NAFLD 和/或 NASH，成人患者中抗糖尿病、抗高血压和调脂药物处方趋势的差异。
我们使用 2013 年 1 月至 2020 年 12 月的大型索赔数据库进行了横断面分析。
在 7716908 人中，确定了 47157 例 T2D 患者、180050 例高血压患者和 191348 例血脂异常患者。共有 8897 例、16451 例和 24762 例患者分别患有 NAFLD，435 例、523 例和 1033 例患有 NASH，同时患有 T2D、高血压和血脂异常。在抗糖尿病药物中，钠-葡萄糖协同转运蛋白-2 抑制剂（SGLT2is）和噻唑烷二酮在 NAFLD 患者中的使用频率高于非 NAFLD 患者（噻唑烷二酮：1.4%和 2.8%和 SGLT2is：17.8%和 25.9%，用于非 NAFLD 和 NAFLD，分别在[2019-2020]）。在抗高血压药物中，血管紧张素 II 受体拮抗剂在 NAFLD 患者中的处方比例略高（33.6%比 39.0%）。关于调脂药物，贝特类药物在 NAFLD 患者中更常被开处（10.3%比 18.4%）。
特定药物倾向于开给 NAFLD 患者。然而，处方比例的差异并不显著。需要进一步研究以确认药物对 NAFLD 或 NASH 患者预后的影响。
