Kurajoh Masafumi, Akari Seigo, Nakamura Takashi, Ihara Yasutaka, Imai Takumi, Morioka Tomoaki, Emoto Masanori
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Medical Affairs Department, Sanwa Kagaku Kenkyusho Co., Ltd., Nagoya, Aichi, Japan.
Front Pharmacol. 2024 Jan 16;15:1230562. doi: 10.3389/fphar.2024.1230562. eCollection 2024.
Urate-lowering drugs (ULDs) have been approved for treatment of asymptomatic hyperuricemia and gout in Japan. Although serum urate levels and rates of gout onset are known to have seasonal variations, no survey results regarding the seasonality of ULD prescriptions for asymptomatic hyperuricemia and gout have been reported. A large-scale database of medical claims in Japan filed between January 2019 and December 2022 was accessed. In addition to total size of the recorded population for each month examined, the numbers of patients every month with newly prescribed ULDs for asymptomatic hyperuricemia and gout were noted, based on the International Classification of Diseases, 10th Revision, codes E79.0 and M10. The results identified 201,008 patients with newly prescribed ULDs (median age 49.0 years, male 95.6%). Of those, 64.0% were prescribed ULDs for asymptomatic hyperuricemia and 36.0% for gout. The proportion of new ULD prescriptions was seasonal, with that significantly ( < 0.001) higher in summer (June-August) [risk ratio (RR) 1.322, 95% CI 1.218 to 1.436] and autumn (September-November) (RR 1.227, 95% CI 1.129-1.335) than in winter (December-February), whereas the proportion in spring (March-May) was not significantly different from winter. There was no significant difference after stratification by drug type (uric acid production inhibitor/uricosuric agent) or size of the medical institution, nor subgrouping by age or sex (p for interaction = 0.739, 0.727, 0.886, and 0.978, respectively). On the other hand, the proportions of new ULD prescriptions for asymptomatic hyperuricemia were significantly lower and for gout significantly higher in spring than winter, while those were similar in summer and autumn for both groups (p for interaction<0.001). The present findings indicate that new prescriptions for ULDs to treat asymptomatic hyperuricemia or gout in Japan show seasonal differences, with higher rates noted in summer and autumn as compared to winter.
在日本，降尿酸药物（ULDs）已被批准用于治疗无症状高尿酸血症和痛风。虽然已知血清尿酸水平和痛风发病几率存在季节性变化，但尚无关于无症状高尿酸血症和痛风的ULDs处方季节性的调查结果报告。我们访问了日本2019年1月至2022年12月期间提交的大规模医疗索赔数据库。除了记录每个检查月份的总人口规模外，还根据国际疾病分类第10版代码E79.0和M10记录了每月新开具ULDs用于无症状高尿酸血症和痛风的患者人数。结果确定了201,008名新开具ULDs的患者（中位年龄49.0岁，男性占95.6%）。其中，64.0%的患者因无症状高尿酸血症开具ULDs，36.0%的患者因痛风开具ULDs。新的ULDs处方比例具有季节性，夏季（6月至8月）[风险比（RR）1.322，95%置信区间1.218至1.436]和秋季（9月至11月）（RR 1.227，95%置信区间1.129 - 1.335）的比例显著（<0.001）高于冬季（12月至2月），而春季（3月至5月）的比例与冬季无显著差异。按药物类型（尿酸生成抑制剂/促尿酸排泄剂）或医疗机构规模分层，以及按年龄或性别分组后，均无显著差异（交互作用p值分别为0.739、0.727、0.886和0.978）。另一方面，春季无症状高尿酸血症的新ULDs处方比例显著低于冬季，痛风的新ULDs处方比例显著高于冬季，而夏季和秋季两组的比例相似（交互作用p<0.001）。目前的研究结果表明，在日本，用于治疗无症状高尿酸血症或痛风的ULDs新处方存在季节性差异，夏季和秋季的开具率高于冬季。
