Analysis of the Medication Persistence Rate for and Adherence to Oral 5-Aminosalicylic Acid Preparations in Japanese Patients with Ulcerative Colitis: Study Using a Nationwide Claims Database.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestion Pub Date : 2024-01-01 Epub Date: 2024-03-25 DOI:10.1159/000538319

Takumi Ota, Takahiro Takebe, Yutaka Shimizu, Takashi Orido, Hiroyuki Tanaka, Shiro Nakamura

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引用次数: 0

Abstract

Introduction: 5-aminosalicylic acid (5-ASA) is the first-line drug for the treatment of mild-to-moderate ulcerative colitis (UC). Three oral sustained-release formulations are often used. However, no unified view of their actual use in routine medical practice has been presented to date.

Methods: Using a health insurance claims database, we extracted patients with an initial diagnosis of mild-to-moderate UC during the period from December 1, 2017, to March 31, 2022. For the three types of oral 5-ASA formulation, we calculated and compared descriptive statistics of medication persistence rates (MPR), proportions of days covered (PDC), and adherence proportion (PDC ≥80%) in the extracted population.

Results: An oral 5-ASA formulation was used in combination with a topical preparation (cohort 1) in 899 patients, and oral 5-ASA was used alone (cohort 2) in 1,829 patients. In cohort 1, MPR at days 151-180 with concomitant use of topical formulation was significantly higher for the Multi Matrix System™ (MMX) formulation (65.2%) compared with that for pH-dependent formulation (51.7%, p < 0.025), while MPR tended to be higher for MMX than for the time-dependent formulation (56.4%, not significant). During days 151-180 after starting the oral formulation, MPR for MMX (66.7% and 65.8%) was higher than for pH-dependent (55.9% and 55.3%) and time-dependent (57.6% and 55.9%) formulations in cohorts 1 + 2 and 2, respectively. In cohort 1, there was a significant difference between MMX (68.3%) and pH-dependent (57.1%) formulations, but no significant difference was seen with time-dependent formulations (61.8%). In terms of the proportion of adherence until day 180, MMX was significantly better than the other formulations.

Conclusion: The analyses of the three oral 5-ASA formulations suggested that both MPR and medication adherence were better for the MMX formulation than for time-dependent or pH-dependent formulations.

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日本溃疡性结肠炎患者口服 5-氨基水杨酸制剂的用药持续率和依从性分析：使用全国索赔数据库进行的研究。

导言 5-氨基水杨酸（5-ASA）是治疗轻度至中度溃疡性结肠炎（UC）的一线药物。目前常用的有三种口服缓释制剂。然而，迄今为止还没有关于它们在常规医疗实践中实际使用情况的统一观点。方法我们利用医疗保险理赔数据库，提取了 2017 年 12 月 1 日至 2022 年 3 月 31 日期间初步诊断为轻度至中度 UC 的患者。针对三种口服 5-ASA 制剂，我们计算并比较了提取人群中的用药持续率 (MPR)、覆盖天数比例 (PDC) 和依从性比例（PDC ≥ 80%）的描述性统计。结果 899 名患者口服 5-ASA 制剂与外用制剂联合使用（队列 1），1829 名患者单独口服 5-ASA 制剂（队列 2）。在队列 1 中，在同时使用外用制剂的第 151-180 天，Multi Matrix SystemTM (MMX) 制剂的 MPR（65.2%）显著高于 pH 依赖性制剂（51.7%，p < 0.025），而 MMX 的 MPR 往往高于时间依赖性制剂（56.4%，无显著性）。在开始口服制剂后的第 151-180 天，组群 1+2 和组群 2 中，MMX（66.7% 和 65.8%）的 MPR 分别高于 pH 依赖性制剂（55.9% 和 55.3%）和时间依赖性制剂（57.6% 和 55.9%）。在组群 1 中，MMX（68.3%）与 pH 依赖性制剂（57.1%）之间存在显著差异，但与时间依赖性制剂（61.8%）之间没有显著差异。在坚持服用至第 180 天的比例方面，MMX 明显优于其他制剂。结论对三种口服 5-ASA 制剂的分析表明，MMX 制剂的 MPR 和服药依从性均优于时间依赖性制剂或 pH 依赖性制剂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestion 医学-胃肠肝病学

CiteScore

7.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.