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在诊断为非感染性葡萄膜炎的新登记索赔数据库患者中使用全身皮质类固醇:真实世界索赔数据库分析的结果。

Use of systemic corticosteroids in patients newly registered at a claims database with a diagnosis of non-infectious uveitis: results from a real-world claims database analysis.

机构信息

Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.

Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan.

出版信息

Jpn J Ophthalmol. 2022 Jul;66(4):394-404. doi: 10.1007/s10384-022-00923-2. Epub 2022 Jun 7.

Abstract

PURPOSE

To investigate the real-world dose of systemic corticosteroids in the treatment of non-infectious uveitis (NIU) in Japan.

STUDY DESIGN

A retrospective, observational study.

METHODS

Patients newly registered at the Japan Medical Data Center health insurance claims database with a diagnosis of NIU who received systemic corticosteroids were identified, and their systemic corticosteroid dose (prednisolone equivalent) was assessed over 12 months of treatment (data extraction period: January 2008 to May 2017).

RESULTS

The mean cumulative systemic corticosteroid dose in 12 months in 1641 new patients with NIU who received systemic corticosteroids was 593.7 mg. The mean systemic corticosteroid dose was highest at month 1 (10.7, 218.1, 16.7, and 23.0 mg/day in Behçet's disease [BD]-associated NIU [n = 19], Vogt-Koyanagi-Harada [VKH] disease-associated NIU [n = 49], sarcoidosis-associated NIU [n = 27], and "undifferentiated NIU" [NIU without specific primary disease information, n = 1545], respectively) and decreased over time. Systemic corticosteroids were prescribed at month 12 to 68.4%, 22.4%, 44.4%, and 5.6% of patients with BD-associated NIU, VKH disease-associated NIU, sarcoidosis-associated NIU, and undifferentiated NIU, respectively (mean dose, 6.0-14.3 mg/day). Multivariate regression analysis identified female sex, middle age (30 to < 40 years), VKH disease, and immunosuppressive agent use as background factors associated with higher systemic corticosteroid dose.

CONCLUSIONS

The systemic corticosteroid dose was highest at month 1 and decreased over time in all disease categories. This database research revealed that some patients with NIU continued being prescribed systemic corticosteroids for at least 1 year.

摘要

目的

研究日本非感染性葡萄膜炎(NIU)治疗中全身皮质类固醇的实际剂量。

研究设计

回顾性、观察性研究。

方法

在日本医疗保险索赔数据库中,新诊断为 NIU 并接受全身皮质类固醇治疗的患者被确定,并评估他们在 12 个月的治疗期间(数据提取期:2008 年 1 月至 2017 年 5 月)的全身皮质类固醇剂量(泼尼松龙当量)。

结果

1641 例新诊断为 NIU 并接受全身皮质类固醇治疗的患者中,12 个月内累积全身皮质类固醇剂量的平均值为 593.7mg。在第 1 个月,全身皮质类固醇剂量最高(BD 相关性 NIU [n=19]、VKH 相关性 NIU [n=49]、结节病相关性 NIU [n=27]和“未分化 NIU”[无特定原发性疾病信息,n=1545],分别为 10.7、218.1、16.7 和 23.0mg/天),并且随着时间的推移而减少。BD 相关性 NIU、VKH 相关性 NIU、结节病相关性 NIU 和未分化 NIU 患者在第 12 个月分别有 68.4%、22.4%、44.4%和 5.6%接受全身皮质类固醇治疗(平均剂量分别为 6.0-14.3mg/天)。多变量回归分析确定女性、中年(30 岁至<40 岁)、VKH 疾病和免疫抑制剂的使用是与更高全身皮质类固醇剂量相关的背景因素。

结论

所有疾病类别中,全身皮质类固醇剂量在第 1 个月最高,并随着时间的推移而降低。这项数据库研究表明,一些 NIU 患者至少接受了 1 年的全身皮质类固醇治疗。

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