Seo Min Sook, Hillen Jodie, Kang Dong Yoon, Pratt Nicole, Shin Ju-Young
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.
Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.
Front Pharmacol. 2022 May 20;13:834116. doi: 10.3389/fphar.2022.834116. eCollection 2022.
Inhaled Corticosteroids (ICSs) and oral Leukotriene Receptor Antagonists (LTRAs) are commonly prescribed asthma preventers, however, concerns have been raised as to whether montelukast (LTRA) is associated with an increase in occurrences of neuropsychiatric side effects in children. Our study was conducted to observe prescribing patterns of asthma preventers among paediatric patients specifically focusing on ICSs and LTRAs between Australia and South Korea to see intercountry differences in the use of these medicines. The Health Insurance Review and Assessment Paediatric Patients Sample dataset for South Korea and data provided by Services Australia were used in the study. Paediatric patients aged between 3 and 19 with more than one dispensing of an asthma preventer and at least one reliever between 1 Jan 2018 and 31 December 2018 were selected. Prevalence per 1,00,000 persons and standardised prevalence were estimated. A total of 3,58,470 patients (2,04,270 from South Korea and 1,54,200 from Australia) were included in the study. A higher prevalence of ICS-based inhalers was seen in Australia with 80.1% compared to 13.5% in South Korea. In addition, Australia showed a stronger tendency of prescribing high dose ICS-based inhalers compared to South Korea with 22.9% vs. 4.9%. In contrast, use of LTRAs was more prevalent in South Korea with 57.6% while in Australia, montelukast was the only LTRA dispensed at a proportion of 18.9%. Moreover, 29.9% of xanthines which are orally available preventers, were prescribed more frequently in South Korea compared to Australia (0.1%). Australia showed a tendency of prescribing ICS-based preventers whereas South Korea exhibited a preference towards the oral LTRAs. Given the potential risk of neuropsychiatric side effects among paediatric patients with montelukast, reasons for the high use of montelukast in South Korea should be investigated further.
吸入性糖皮质激素（ICSs）和口服白三烯受体拮抗剂（LTRAs）是常用的哮喘预防药物，然而，人们对孟鲁司特（LTRA）是否会增加儿童神经精神副作用的发生率提出了担忧。我们开展这项研究是为了观察儿科患者中哮喘预防药物的处方模式，特别关注澳大利亚和韩国之间ICSs和LTRAs的使用情况，以了解这些药物在不同国家的使用差异。韩国的健康保险审查与评估儿科患者样本数据集以及澳大利亚服务局提供的数据被用于本研究。选取了2018年1月1日至2018年12月31日期间年龄在3至19岁、有不止一次哮喘预防药物配药且至少有一次缓解药物配药的儿科患者。估计了每10万人的患病率和标准化患病率。该研究共纳入358470名患者（韩国204270名，澳大利亚154200名）。澳大利亚基于ICS的吸入器患病率更高，为80.1%，而韩国为13.5%。此外，与韩国相比，澳大利亚开具高剂量基于ICS的吸入器的趋势更强，分别为22.9%和4.9%。相比之下，LTRAs在韩国的使用更为普遍，为57.6%，而在澳大利亚，孟鲁司特是唯一配药的LTRA，占比为18.9%。此外，作为口服预防药物的黄嘌呤类药物，韩国的处方频率（29.9%）高于澳大利亚（0.1%）。澳大利亚表现出开具基于ICS的预防药物的趋势，而韩国则更倾向于口服LTRAs。鉴于孟鲁司特在儿科患者中存在神经精神副作用的潜在风险，韩国孟鲁司特高使用率的原因应进一步调查。
