Noda Tatsuya, Kuwaki Kotaro, Machida Munehito, Okumura Yasuyuki, Nishioka Yuichi, Myojin Tomoya, Imamura Tomoaki
Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan.
Department of Public Health, Kurume University School of Medicine, Fukuoka, Japan.
PLoS One. 2024 Dec 30;19(12):e0316181. doi: 10.1371/journal.pone.0316181. eCollection 2024.
The 5-aminosalicylic acid (5-ASA) agents are first-line drugs for ulcerative colitis (UC). However, intolerance as well as other issues have been reported for these drugs, making it difficult to sustain this treatment; accordingly, the persistence of 5-ASA is an important indicator of UC treatment strategy. We aimed to analyze the persistence of 5-ASA in patients with UC in Japan. This was a 1-year, nationwide, population-based cohort study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. We identified patients who were assigned UC-related disease codes and newly prescribed 5-ASA between April 2015 and September 2019 and specified the number of days until 5-ASA prescriptions were interrupted during a follow-up of up to 365 days. Among the 137 million patients who were covered by the universal health insurance in Japan during the study period, 68,234 eligible patients were identified. The 5-ASA persistence in these patients were 87.2%, 65.6%, and 56.4% after 30, 180, and 365 days, respectively. The 5-ASA persistence by subtype at 365 days was 54.4%, 56.4%, and 57.6% for time-dependent, pH-dependent, and multi-matrix system types, respectively. The 5-ASA persistence rate after 365 days was 65.0% for those under 20 years of age, 51.0% for those 20-39 years old, 57.5% for those 40-64 years old, and 65.5% for those over 64 years of age. This study revealed the 1-year persistence of newly prescribed 5-ASA in patients with UC newly prescribed 5-ASA in Japan, based on a national claims database of more than 100 million individuals.
5-氨基水杨酸（5-ASA）制剂是溃疡性结肠炎（UC）的一线药物。然而，这些药物存在不耐受等问题，使得维持这种治疗变得困难；因此，5-ASA的持续性是UC治疗策略的一个重要指标。我们旨在分析日本UC患者中5-ASA的持续性。这是一项为期1年的全国性基于人群的队列研究，使用日本医疗保险索赔和特定健康检查国家数据库。我们确定了在2015年4月至2019年9月期间被分配UC相关疾病代码并新开具5-ASA的患者，并确定了在长达365天的随访期间5-ASA处方中断前的天数。在研究期间日本全民健康保险覆盖的1.37亿患者中，确定了68234名符合条件的患者。这些患者在30天、180天和365天后的5-ASA持续性分别为87.2%、65.6%和56.4%。365天时，时间依赖性、pH依赖性和多基质系统类型的5-ASA亚型持续性分别为54.4%、56.4%和57.6%。365天后，20岁以下患者的5-ASA持续性率为65.0%，20-39岁患者为51.0%，40-64岁患者为57.5%，64岁以上患者为65.5%。这项基于超过1亿人的国家索赔数据库的研究揭示了日本新开具5-ASA的UC患者中新开具的5-ASA的1年持续性。
