日本系统性红斑狼疮治疗的延迟全球标准化及地区差异：一项基于日本全国健康保险理赔与特定健康检查国家数据库的全国性研究。

Delayed global standardization and prefectural disparities in systemic lupus erythematosus treatment in Japan: A nationwide study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan.

作者信息

Yokogawa Naoto, Sakai Ryoko, Matsushita Masakazu, Shimizu Masaki, Inoue Yuzaburo, Inoue Eisuke, Yamaji Ken, Mori Masaaki, Miyamae Takako

机构信息

Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.

Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Tokyo, Japan.

出版信息

Mod Rheumatol. 2025 Feb 21;35(2):294-299. doi: 10.1093/mr/roae072.

DOI:10.1093/mr/roae072

PMID:39167459

Abstract

OBJECTIVES

The aim of this study was to evaluate the status of the global standardization of, and prefectural differences in, systemic lupus erythematosus (SLE) treatments in Japan.

METHODS

The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB Japan) was used. A patient with SLE was defined as having a disease with ICD-10 code M321 or M329 between April 2019 and March 2020, for which oral corticosteroids, immunosuppressive agents, or biologic agents were prescribed at least once during a given month. SLE treatments were evaluated by treatment centre type and prefecture.

RESULTS

In total, 74,277 patients met the definition of SLE. The SLE prevalence was 60 per 100,000 (range: 47-102 per 100,000 by prefecture). Nationwide, 79.4% of the patients (range: 52.1-93.3% by prefecture) visited a specialized treatment centre (STC); 37.4% (range: 26.4-51.3% by prefecture) received only oral corticosteroids, with fewer of these patients visiting an STC than a non-STC (34.8% and 49.7%, P < .001); and 21.4% (range: 10.7-35.0%) received hydroxychloroquine, with more of these patients visiting an STC than a non-STC (23.0% and 13.5%; P < .001).

CONCLUSIONS

The NDB Japan demonstrated the delayed global standardization of, and prefectural disparity in, SLE treatments in Japan.

摘要

目的

本研究旨在评估日本系统性红斑狼疮（SLE）治疗的全球标准化状况以及地区差异。

方法

使用日本全国健康保险理赔和特定健康检查数据库（NDB Japan）。将2019年4月至2020年3月期间患有ICD-10编码为M321或M329疾病且在某一月至少接受过一次口服糖皮质激素、免疫抑制剂或生物制剂治疗的患者定义为SLE患者。根据治疗中心类型和地区对SLE治疗进行评估。

结果

共有74277例患者符合SLE定义。SLE患病率为每10万人中有60例（各地区范围：每10万人中47 - 102例）。在全国范围内，79.4%的患者（各地区范围：52.1% - 93.3%）前往专科治疗中心（STC）就诊；37.4%的患者（各地区范围：26.4% - 51.3%）仅接受口服糖皮质激素治疗，与非STC就诊患者相比，前往STC就诊的此类患者较少（分别为34.8%和49.7%，P < 0.001）；21.4%的患者（各地区范围：10.7% - 35.0%）接受羟氯喹治疗，与非STC就诊患者相比，前往STC就诊的此类患者较多（分别为23.0%和13.5%；P < 0.001）。