在过去的 10 年中，6 岁以下的日本患者食物过敏的患病率增加了 1.7 倍。

Prevalence of food allergy increased 1.7 times in the past 10 years among Japanese patients below 6 years of age.

机构信息

Novartis Pharma K.K., Tokyo, Japan.

JMDC Co. Ltd, Tokyo, Japan.

出版信息

Pediatr Allergy Immunol. 2024 Jul;35(7):e14192. doi: 10.1111/pai.14192.

DOI:10.1111/pai.14192

PMID:39007449

Abstract

BACKGROUND

While food allergy (FA) has been increasingly recognized as a growing public health burden worldwide, epidemiological studies on FA in Japan are limited.

METHODS

This was a noninterventional, observational study using the administrative claims data from 2010 to 2019 (10 years). Patients with physician-diagnosed FA in Japan (prevalent cohort) were divided into high-risk or low-risk cohorts using adrenaline prescription. The high-risk cohort was further divided into anaphylaxis or nonanaphylaxis cohort based on the occurrence of anaphylaxis or a serious allergic reaction (SAR) during 1 year after adrenaline prescription. The primary objective was to examine yearly prevalence of FA. The secondary objectives were to describe demographics/clinical characteristics and healthcare resource utilization (HCRU), to evaluate the number of occurrences of anaphylaxis/SAR in the high-risk cohort, and the impact of anaphylaxis/SAR on HCRU.

RESULTS

The overall standardized prevalence rate was 0.325% (95% confidence interval [CI], 0.311-0.339) in 2010 and 0.797% (95% CI, 0.790-0.804) in 2019 and predominant in patients age <6 years (preschool; 3.377% [95% CI, 3.229-3.525] in 2010 and 5.726% [95% CI, 5.663-5.789] in 2019). Majority of FA patients (>80%) were children/adolescent throughout the 10 years. While high-risk cohort was a relatively minor population (8.5% in the prevalent cohort in 2019), the occurrence of anaphylaxis/SAR in the high-risk cohort was 227,690/100,000 patient-years. Multivariate analysis showed a significant increase in HCRU variables in the anaphylaxis versus nonanaphylaxis cohort (e.g., 2.08 [95% CI, 2.05-2.11] times more FA-related outpatient visits).

CONCLUSIONS

Prevalence of FA increased in a statistically significant way from 2010 to 2019; 1.7-fold increase was observed in patients <6 years old. Patients in the high-risk cohort appear to have suffered from frequent anaphylaxis/SAR, highlighting an unmet medical need for FA patients at "high-risk," considering the unavailability of approved medications to prevent anaphylaxis/SAR.

摘要

背景

虽然食物过敏（FA）已被越来越多地认为是全球日益严重的公共卫生负担，但日本的 FA 流行病学研究有限。

方法

这是一项使用 2010 年至 2019 年（10 年）的行政索赔数据进行的非干预性、观察性研究。日本有医生诊断为 FA 的患者（现患队列）根据肾上腺素处方分为高风险或低风险队列。根据肾上腺素处方后 1 年内是否发生过敏反应或严重过敏反应（SAR），高风险队列进一步分为过敏反应或非过敏反应队列。主要目的是检查 FA 的年患病率。次要目的是描述人口统计学/临床特征和医疗资源利用（HCRU），评估高风险队列中过敏反应/SAR 的发生次数，以及过敏反应/SAR 对 HCRU 的影响。

结果

2010 年总体标准化患病率为 0.325%（95%置信区间 [CI]，0.311-0.339），2019 年为 0.797%（95% CI，0.790-0.804），主要发生在<6 岁患者（学龄前；2010 年为 3.377%[95% CI，3.229-3.525]，2019 年为 5.726%[95% CI，5.663-5.789]）。10 年来，大多数 FA 患者（>80%）为儿童/青少年。虽然高风险队列是一个相对较小的人群（2019 年现患队列中的 8.5%），但高风险队列中过敏反应/SAR 的发生频率为 227,690/100,000 患者年。多变量分析显示，过敏反应组与非过敏反应组的 HCRU 变量显著增加（例如，与非过敏反应组相比，FA 相关门诊就诊次数增加 2.08 倍[95%CI，2.05-2.11]）。