Treatment trends and risks of corticosteroid use in adult primary immune thrombocytopenia: a claims database study in Japan.

IF 1.7 4区医学 Q3 HEMATOLOGY

International Journal of Hematology Pub Date : 2025-03-01 Epub Date: 2024-12-12 DOI:10.1007/s12185-024-03897-8

Hirokazu Kashiwagi, Isao Miura, Naohiko Terasawa, Ken-Ichi Iwayama, Yuka Furukawa, Makoto Kanenishi

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引用次数: 0

Abstract

Recent trends in the treatment of primary immune thrombocytopenia (ITP) were investigated using a claims database that included data from 16,161 Japanese patients with ITP collected from April 2014 to August 2022. Of the 4144 adult patients analyzed, 1276 received corticosteroids. The mean and median durations of corticosteroid use were 115.31 and 41 days, respectively. The time to withdrawal of corticosteroids was significantly shorter in 2020 to 2021 than in 2015 to 2019. Additionally, the number of prescriptions for thrombopoietin receptor agonists increased from 2015 to 2021 and exceeded that of corticosteroids in 2021. While these results suggest a trend towards reduction in corticosteroid use in real-world settings in Japan, 12.00% of patients received a corticosteroid dose of ≥ 10 mg/day at Week 12. Furthermore, 23.05% of patients continued to receive corticosteroids at Week 24, indicating that some patients were still receiving long-term corticosteroid treatment. The risk of adverse outcomes was significantly associated with corticosteroid use. In conclusion, new treatment options may lead to more sophisticated ITP management with less corticosteroid use, although further research and reconsideration of clinical practice guidelines is needed.

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在成人原发性免疫性血小板减少症中使用皮质类固醇的治疗趋势和风险：日本的一项索赔数据库研究

使用索赔数据库调查原发性免疫性血小板减少症（ITP）治疗的最新趋势，该数据库包括2014年4月至2022年8月收集的16,161名日本ITP患者的数据。在分析的4144名成年患者中，1276名接受了皮质类固醇。皮质类固醇使用的平均和中位持续时间分别为115.31天和41天。2020 - 2021年停用皮质类固醇的时间明显短于2015 - 2019年。此外，从2015年到2021年，血小板生成素受体激动剂的处方数量有所增加，并在2021年超过了皮质类固醇。虽然这些结果表明在日本现实环境中皮质类固醇的使用有减少的趋势，但12.00%的患者在第12周接受了≥10mg /天的皮质类固醇剂量。此外，23.05%的患者在第24周继续接受糖皮质激素治疗，表明部分患者仍在接受长期糖皮质激素治疗。不良后果的风险与皮质类固醇的使用显著相关。总之，新的治疗方案可能导致更复杂的ITP管理和更少的皮质类固醇使用，尽管需要进一步的研究和重新考虑临床实践指南。

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

International Journal of Hematology 医学-血液学

CiteScore

3.90

自引率

4.80%

发文量

223

审稿时长

6 months

期刊介绍： The International Journal of Hematology, the official journal of the Japanese Society of Hematology, has a long history of publishing leading research in hematology. The journal comprises articles that contribute to progress in research not only in basic hematology but also in clinical hematology, aiming to cover all aspects of this field, namely, erythrocytes, leukocytes and hematopoiesis, hemostasis, thrombosis and vascular biology, hematological malignancies, transplantation, and cell therapy. The expanded [Progress in Hematology] section integrates such relevant fields as the cell biology of stem cells and cancer cells, and clinical research in inflammation, cancer, and thrombosis. Reports on results of clinical trials are also included, thus contributing to the aim of fostering communication among researchers in the growing field of modern hematology. The journal provides the best of up-to-date information on modern hematology, presenting readers with high-impact, original work focusing on pivotal issues.