Medical Affairs Department, Sanwa Kagaku Kenkyusho Co., Ltd., Aichi, Japan.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
J Clin Hypertens (Greenwich). 2022 Aug;24(8):1068-1075. doi: 10.1111/jch.14539. Epub 2022 Jul 12.
Hyperuricemia causes gout and has also been associated with metabolic syndrome and cardiovascular disease. Uric acid-lowering drugs (ULDs) are used to reduce uric acid levels for the treatment of hyperuricemia and gout. However, there is a lack of robust and real-world data on the history and treatment of patients with newly diagnosed hyperuricemia or gout in Japan. This retrospective, longitudinal, historical cohort study determined the characteristics of patients with hyperuricemia and/or gout, and prescription of, and adherence to, ULDs using data from the JMDC Claims Database. The primary evaluation population included 64 677 patients with newly diagnosed hyperuricemia and/or gout. Of these, only 26 501 (41.0%) had a prescription for ULDs at diagnosis. Even when ULDs were prescribed, the persistence rate of prescriptions declined over time, with a 54.4% persistence rate for ULDs at 12 months after the index diagnosis. In subgroups of patients with or without hypertension and diabetes, the rate of ULD prescription continuation was significantly higher in those with comorbidities than in those without (76.8% vs. 42.6% in those with vs. without hypertension, and 78.7% vs. 52.2% in those with vs. without diabetes). These finding suggest that therapeutic interventions to lower serum uric acid levels are under-utilized for patients with newly diagnosed hyperuricemia and/or gout in Japan.
高尿酸血症可引起痛风，也与代谢综合征和心血管疾病有关。尿酸降低药物（ULD）用于降低尿酸水平以治疗高尿酸血症和痛风。然而，在日本，针对新诊断的高尿酸血症或痛风患者的病史和治疗情况，缺乏稳健且真实世界的数据。本回顾性、纵向、历史队列研究使用 JMDC 理赔数据库的数据，确定了高尿酸血症和/或痛风患者的特征，以及 ULD 的处方情况和患者的用药依从性。主要评估人群包括 64677 例新诊断为高尿酸血症和/或痛风的患者。其中，仅有 26501 例（41.0%）在诊断时开具了 ULD 处方。即使开具了 ULD 处方，处方的持续时间也会随时间推移而下降，在索引诊断后 12 个月时，ULD 处方的持续率为 54.4%。在伴有或不伴有高血压和糖尿病的患者亚组中，合并症患者 ULD 处方续用率显著高于无合并症患者（高血压患者中分别为 76.8%和 42.6%，糖尿病患者中分别为 78.7%和 52.2%）。这些结果表明，在日本，新诊断的高尿酸血症和/或痛风患者的血清尿酸水平降低治疗干预措施的应用不足。
