Current Medical Research and Opinion最新文献

{"title":"Effects of the Part D Senior Savings Model on racial and ethnic disparities in healthcare costs.","authors":"Chi Chun Steve Tsang, Xiangjun Zhang, Ashley Ellis, Jessie Jiaqi Zeng, Junling Wang","doi":"10.1080/03007995.2025.2479780","DOIUrl":"10.1080/03007995.2025.2479780","url":null,"abstract":"<p><strong>Objective: </strong>The Centers for Medicare & Medicaid Services tested the Part D Senior Savings Model (\"PDSS Model\") in 2021, capping monthly out-of-pocket (OOP) insulin costs at $35. Diabetes disproportionately affects racial/ethnic minorities compared to their non-Hispanic White (White) counterparts, so this study compared the changes in racial/ethnic disparities in healthcare costs among insulin users between Medicare and non-Medicare populations in 2021.</p><p><strong>Methods: </strong>This study analyzed the Medical Expenditure Panel Survey (2020-2021). The intervention group comprised Medicare beneficiaries aged ≥65, while the comparison group included a near-elderly non-Medicare population. The study outcomes included annual OOP/total costs in 2021 dollars for insulin, medication, health services (medical), and overall healthcare. A difference-in-differences-in-differences approach was employed to assess the PDSS Model's effects between White and each racial/ethnic minority group.</p><p><strong>Results: </strong>The weighted sample included 1,056,386 insulin users (53.89% intervention). In 2020, among the intervention group, non-Hispanic Black (Black) and Hispanic had similar or higher insulin costs than White patients. Black-White differences in OOP insulin costs were lowered more among the intervention group (cost ratio [CR] = 0.12, 95% confidence interval = 0.06-0.22) than the comparison group. Black-White differences in OOP costs for medication, health services, and overall healthcare widened more among the intervention group by 61-64%. These patterns were not seen for other racial/ethnic disparities.</p><p><strong>Conclusions: </strong>Among insulin users, Black may have benefited more from the PDSS Model than White patients, which may be associated with enhanced insulin access and lower needs for other healthcare. Future studies should examine the long-term and heterogeneous impact of the PDSS Model.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-10"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world cross-sectional study evaluating patient characteristics, disease burden, and treatment approaches in people with obesity disease in Japan.","authors":"Tomohiro Tanaka, Taisuke Kojima, Swathi Pathadka, Swarna Khare, Andrea Leith, Victoria Higgins, Tomotaka Shingaki","doi":"10.1080/03007995.2025.2486167","DOIUrl":"10.1080/03007995.2025.2486167","url":null,"abstract":"<p><strong>Aim: </strong>To describe clinical characteristics, disease burden, and treatment patterns among people with obesity disease (PwOD) in Japan, using data from the Adelphi Real World Obesity Disease Specific Programme™ (DSP).</p><p><strong>Methods: </strong>Secondary data from the Japanese DSP cohort (July to December 2022) were analyzed. PwOD had a BMI ≥25 kg/m² and ≥1 obesity-related complications (ORCs). Outcomes were summarized for all PwOD or stratified by obesity class (BMI ≥25-<35 or ≥35 kg/m² [high-degree obesity disease]) and use of anti-obesity medications (AOMs).</p><p><strong>Results: </strong>The study included 442 PwOD (mean age: 52.8 years; 54.8% males; BMI ≥25-<35 kg/m²: 64.5%; BMI ≥35 kg/m²: 35.5%; AOM users: n = 228; non-AOM users: n = 214). High-degree obesity disease was associated with worsened SF-36v2 scores (Physical Component Summary, Physical Functioning, Bodily Pain and General Health), greater activity impairment, and reduced work productivity. Common weight management approaches were diet (79.9%) and exercise (51.1%). Common prescription AOMs included traditional herbal medicine (67.5%) and mazindol (21.1%). People with high-degree obesity disease (BMI ≥35 vs ≥25-<35 kg/m²) used more prescription AOMs (57.3% vs 48.4%), behavioral therapy (9.6% vs 1.8%), and weight loss surgery (2.6% vs 0.4%). The difference in weight reduction between AOM and non-AOM users was modest.</p><p><strong>Conclusions: </strong>People with high-degree obesity disease experienced greater disease burden. Diet and exercise are common for weight management, while behavioral therapy is less frequently implemented. These findings highlight the challenges and unmet medical needs in treating obesity in Japan and could inform better treatment strategies in Japan and globally among the Asian population.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-25"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and public involvement and engagement in real world data and evidence research across the medicines development cycle: a rapid review of peer-reviewed literature and NICE technology appraisals.","authors":"Sally-Anne Dews, Arisa Oluwatomi, Alex Inskip, Opeyemi Agbeleye, Sarah Markham, Peter Latchford, Natalie Bohm, Polly Westergaard, Rebecca Butfield, Alexia Campbell-Burton, Nick Meader, Akvile Stoniute","doi":"10.1080/03007995.2025.2482668","DOIUrl":"10.1080/03007995.2025.2482668","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this rapid review is to understand the reporting, role and quality of patient and public involvement and engagement (PPIE) in real world data and evidence (RWDE) research across the medicines development cycle.</p><p><strong>Methods: </strong>We comprehensively searched, with no date restrictions, Medline and Embase databases for peer-reviewed literature and conference abstracts (Embase only) reporting PPIE in RWD studies. We also assessed PPIE in a sample of 100 NICE technology appraisals (TAs) comprising both single technology appraisals (STAs) and highly specialized technologies (HSTs). We used standard methods for screening and data extraction. In addition, we used the Patient Focused Medicines Development (PFMD)'s Patient Engagement Quality Guidance (PEQG) as a framework to assess the quality of PPIE. We planned to conduct narrative synthesis of included studies, however there were insufficient studies and data reported.</p><p><strong>Results: </strong>We included three RWD studies that reported PPIE from the peer-reviewed literature and two NICE HSTs. One of the HSTs included data from one of the peer-reviewed journal articles. Reporting of PPIE in included studies was limited. No studies reported a PPIE framework and it was unclear how integrated and meaningful PPIE was. Four out of seven of PFMD's quality criteria for PPIE were poorly reported by included studies. This suggests reporting and/or conduct of PPIE requires improvement in RWD studies.</p><p><strong>Conclusions: </strong>Our review found that PPIE was rarely reported in RWDE research and uncovers a need for consistent reporting. For most publications there was insufficient information to judge the extent to which patients and carers, were considered meaningful partners. However, our review provided preliminary evidence that PPIE can influence protocol development, recruitment, and retention methods in RWD studies. More inclusive approaches to PPIE would help interpretation of RWE regarding relevance and importance to patients and carers.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-13"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balanced discussion about bilastine as a truly non-sedating antihistamine.","authors":"Amalia Leceta, Kazuhiro Yanai","doi":"10.1080/03007995.2025.2480190","DOIUrl":"10.1080/03007995.2025.2480190","url":null,"abstract":"","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-2"},"PeriodicalIF":2.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A population-based study of incident prescribing for hypercholesterolaemia and hypertension in Scotland: is the healthcare system recovering from the impact of COVID-19?","authors":"Amanj Kurdi, Morven Millar, Uchenna Nnabuko, Stuart McTaggart, Tanja Mueller, Euan Proud, Barry Melia, Marion Bennie","doi":"10.1080/03007995.2025.2482674","DOIUrl":"10.1080/03007995.2025.2482674","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 pandemic caused significant disruptions in healthcare services, with previous studies estimated that the early months of the pandemic led to a substantial decline in new prescriptions for hypercholesterolemia and hypertension. The long-term recovery of healthcare systems in addressing these gaps remains uncertain. We aimed to assess the recovery of the healthcare system in Scotland regarding the initiation of treatments for hypercholesterolemia and hypertension post-COVID-19 pandemic.</p><p><strong>Method: </strong>This retrospective cohort study analysed prescription data from January 2020 to December 2022 in Scotland, as well as In-hours encounters with general practitioners. Incident prescribing patterns for drugs used in the treatment of hypercholesterolemia and hypertension were compared against pre-pandemic averages from 2018 to 2019. Data were stratified by health regions and socioeconomic status.</p><p><strong>Results: </strong>New treatment initiations for drugs used in the treatment of hypercholesterolemia and hypertension significantly increased from mid-2021 onwards, surpassing pre-pandemic levels. By December 2022, there were approximately 40,000 and 60,000 additional new treatments for drugs used to treat hypercholesterolemia and hypertension, respectively, compared to the expected numbers based on 2018-2019 averages. The stratified analysis showed a relatively higher increase in less deprived quintiles. GP encounter activities mirrored trends in new antihypertensive and lipid-lowering initiations, with a significant reduction starting in March 2020 due to the first COVID-19 lockdown. Encounter rates gradually recovered from May 2020, reaching near pre-pandemic levels by March 2021. Notably, the encounter rate slopes during the reference period (2018-2019) and post-recovery phase (May 2021-December 2022) showed no significant difference [-0.7 (95% CI: -4.0, 2.5) vs. 0.9 (95% CI: -3.1, 4.9)].</p><p><strong>Conclusions: </strong>The observed increase in new treatments for drugs to treat hypercholesterolemia and hypertension suggests recovery of the healthcare system in Scotland following the COVID-19 pandemic. These higher prescribing rates post-pandemic hypothesise potential long-term sequelae associated with COVID-19. The findings demonstrate the potential for improved pharmacotherapy strategies that address both the backlog of untreated cases and new-onset conditions linked to COVID-19. This underscores the need for ongoing surveillance and flexible healthcare responses to manage emerging health challenges effectively. Additionally, our findings suggest novel research areas that could offer a more comprehensive understanding of the COVID-19 pandemic's influence on the prescribing patterns of these widely used medications.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-7"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An international modified Delphi consensus study on the optimal diagnosis and treatment of patients with HFpEF.","authors":"A Sindone, M Abdelhamid, W Almahmeed, J A de Figueiredo Neto, A Jordan-Rios, Y Lopatin, H Sümbül, J C Youn, C E Chiang","doi":"10.1080/03007995.2025.2480736","DOIUrl":"10.1080/03007995.2025.2480736","url":null,"abstract":"<p><strong>Objective: </strong>The global burden of HFpEF is high and, despite developments in available therapies, patient outcomes have not improved significantly. This study aimed to explore the optimal approaches to the diagnosis and treatment of patients with HFpEF and to develop recommendations on how guideline directed medical therapy can be introduced in a more equitable and universal manner.</p><p><strong>Methods: </strong>Using a modified Delphi methodology led by an independent facilitator, a steering group of healthcare practitioners with experience of managing HFpEF identified 41 Likert scale statements across five main domains of focus. This generated an online survey distributed by a third-party provider using a convenience sampling approach to HCPs with experience managing patients with HFpEF.</p><p><strong>Results: </strong>A total of 213 responses were analyzed with 35/41 statements attaining very strong (≥90%) agreement, 4/41 strong (≥75%) agreement, and 2/41 failing to meet the threshold established for consensus (75%). From these results, a total of 8 recommendations to define the optimal approach to diagnosis and treatment of patients with HFpEF are proposed.</p><p><strong>Conclusion: </strong>The burden of HFpEF is set to increase in the future. The high levels of consensus achieved in this study show that there is willingness to implement change and improve patient outcomes for those with this condition. A series of actionable recommendations have been developed based on the levels of agreement attained. It is hoped that the putting the current recommendations into practice will support international efforts to improve HFpEF care.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-11"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the economic impact of premature mortality from cirrhosis in Spain.","authors":"Josep Darbà, Meritxell Ascanio","doi":"10.1080/03007995.2025.2480187","DOIUrl":"10.1080/03007995.2025.2480187","url":null,"abstract":"<p><strong>Objectives: </strong>Excessive alcohol consumption is a major contributor to illness and mortality on a global scale. Per-capita alcohol consumption rose from 5.5 litres in 2005 to 6.4 litres in 2016 and is projected to reach 7.6 litres by 2030. In 2019, alcohol was associated with roughly a quarter of all cirrhosis-related deaths worldwide. The aim of this study is to assess the economic impact of premature mortality due to cirrhosis in Spain.</p><p><strong>Methods: </strong>To estimate the economic impact of premature mortality due to cirrhosis, we utilized the human capital method. This method involved collecting data on mortality rates, average salaries, and unemployment rates. Our objective was to quantify the financial implications of cirrhosis-related deaths, offering valuable insights for policymakers and healthcare professionals.</p><p><strong>Results: </strong>In 2022, 45% of cirrhosis deaths occurred among individuals of working age. This resulted in the loss of 20,190 years of potential life lost (YPLL), contributing to productivity losses totalling €20.4 billion over a decade. These statistics highlight the significant economic and societal burdens associated with cirrhosis mortality.</p><p><strong>Conclusions: </strong>Over the past two decades, there has been a global increase in alcohol consumption, a trend expected to persist and possibly escalate through 2030. As a direct consequence, projections indicate a corresponding increase in cirrhosis-related deaths over the coming decade. This anticipated rise underscores the ongoing public health challenge posed by alcohol-related liver diseases worldwide.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-6"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new paliperidone palmitate formulation: how is it different and where does it fit in our array of choices for long-acting formulations of risperidone and paliperidone?","authors":"Justin Faden, Leslie Citrome","doi":"10.1080/03007995.2025.2482654","DOIUrl":"https://doi.org/10.1080/03007995.2025.2482654","url":null,"abstract":"<p><p>Long-acting injectable (LAI) antipsychotics have been shown to enhance treatment adherence and outcomes in individuals with schizophrenia, schizoaffective disorder, and bipolar disorder. In recent years, the U.S. Food and Drug Administration (FDA) has approved several LAIs with differing amenities of care, such as mode of administration, duration of oral medication supplementation, dosing frequency, needle gauge and size, and injection volume, amongst others. Additionally, several LAIs are distinct formulations of risperidone and paliperidone, making it difficult to distinguish between formulations, and many providers are unfamiliar with these newer agents. In 2024, a once-monthly LAI formulation of paliperidone palmitate, manufactured by Luye (PP1M Luye), was approved for the treatment of schizophrenia and schizoaffective disorder. There are similarities and differences between PP1M (Luye) and once-monthly paliperidone palmitate manufactured by Janssen (PP1M), which was FDA approved in 2009. The focus of this commentary will be to identify common characteristics and differences between these competing formulations, as well as how they relate to the overall compendium of risperidone and paliperidone LAI antipsychotic formulations.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-9"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the pandemic: impaired bone metabolism and risk of SARS-CoV-2 infection.","authors":"Emilio Pariente, Marta Martín-Millán, Daniel Nan, Daniel Martínez-Revuelta, Hector Basterrechea, Javier Pardo, Merelyn Bonome, Sandra Solares, Carmen Ramos, Jose-Manuel Olmos-Martinez, Raquel Pascua, Victor M Martínez-Taboada, José Luis Hernández","doi":"10.1080/03007995.2025.2479782","DOIUrl":"10.1080/03007995.2025.2479782","url":null,"abstract":"<p><strong>Introduction: </strong>While the impact of COVID-19 on bone metabolism has been extensively studied, the inverse relationship remains less understood. This study investigates whether impaired bone metabolism is associated with an increased risk of COVID-19 infection.</p><p><strong>Methods: </strong>We conducted a nested case-control study within a population-based cohort, incorporating Kaplan-Meier analysis (KMA) to assess time to infection (TTI) differences. Propensity score matching (1:2) was performed and validated through standardized mean differences (<0.10), variance ratio (=1), and McFadden's pseudo-<i>R</i>² (=0), ensuring balanced covariates. Bone status was evaluated using a composite index (AOMI), which included five components: P1NP and CTX (bone turnover markers), total hip bone mineral density (BMD-TH), trabecular bone score (TBS), and integral volumetric BMD (IvBMD). Inflammation and insulin resistance (IR) were assessed by albumin-to-globulin ratio (AGR <1.50) and the TG/HDL ratio (>2.50 in women and >2.80 in men), respectively.</p><p><strong>Results: </strong>We analysed 294 COVID-19 cases and 528 controls. AOMI+ individuals had a higher prevalence of COVID-19 (41.5% vs. 33.2%; <i>p</i> = 0.031), an adverse lipid pattern (\"A\" profile: high ApoB, LDL and TC) and pronounced bone changes (higher P1NP and CTX, lower BMD-TH, TBS, and IvBMD). AOMI - individuals were more likely to have metabolic syndrome, displayed a different lipid profile (\"B\" profile: elevated TG, AIP, and TG/HDL ratio), fewer bone alterations, and lower COVID-19 prevalence. TG/HDL ratio was 1.66 ± 1 in \"A\" profile, while it was 2.85 ± 1.4 in \"B\" profile individuals (<i>p</i> = 0.0001). Age acted as an effect modifier, and lowest tercile significantly increased COVID-19 risk associated with AOMI+ [Mantel-Haenszel OR = 1.42 (95%CI: 1.08-1.9); <i>p</i> = 0.022]. KMA identified AOMI+ men and individuals of both sexes in lowest age tercile, as groups with shorter TTI: These younger individuals had high CTX (women), low TBS (men), and high ApoB (both). In multivariable analyses, plasma CTX levels negatively correlated with TTI (adjusted β= -0.325; <i>p</i> = 0.0001). AOMI+ status was associated with increased COVID-19 risk after controlling for confounders, including IR (adjusted OR = 1.51; 95%CI: 1.04-2.10; <i>p</i> = 0.027), although this association weakened when adjusting for AGR (95%CI: 0.99-2.28; <i>p</i> = 0.055). ANCOVA-estimated adjusted TBS means were lower in COVID-19 cases compared to controls (1.259 vs. 1.294; <i>p</i> = 0.013).</p><p><strong>Conclusions: </strong>Impaired bone metabolism was found to be associated with increased COVID-19 risk, in a relationship potentially mediated by underlying inflammation. Elevated osteoclastic activity and a defined lipid profile with high ApoB, TC, LDL levels, played a crucial role in the results. Bone quality parameters more accurately captured COVID-19-related bone changes than BMD.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-13"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional Chinese medicine in synergy with conventional therapy improves renal outcomes and provides survival benefit in patients with systemic lupus erythematosus: a cohort study from the largest health care system in Taiwan.","authors":"Chen-Ying Wei, Chiao-Hsuan Chu, Hsuan-Shu Shen, Po-Chuan Ko, Jiun-Liang Chen, Han-Hua Yu","doi":"10.1080/03007995.2025.2478160","DOIUrl":"10.1080/03007995.2025.2478160","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder that significantly impacts renal function. Despite conventional treatments, morbidity and mortality remain high, necessitating the exploration of safer and more effective therapies, including the potential benefits of Traditional Chinese Medicine (TCM) for improving kidney health and survival rates.</p><p><strong>Methods: </strong>Patients with newly diagnosed SLE with catastrophic illness certificate were retrospectively enrolled from the Chang Gung Research Database (CGRD) between 2005 and 2020. Patients were stratified into groups based on TCM treatment post-diagnosis. Outcomes measured included end-stage renal disease (ESRD) incidence and all-cause mortality, using Cox proportional hazard models and Kaplan-Meier analysis for statistical evaluation.</p><p><strong>Results: </strong>Among 10,462 newly diagnosed SLE patients, 1,831 had received at least 28 days of TCM treatment, while 7,966 had not received TCM treatment. After propensity score matching, there were equally 1,831 individuals in each group, with no significant baseline differences in age, sex, biochemical profiles, or comorbidities. TCM usage was associated with a significantly reduced rate of ESRD over a 0.5-year follow-up (adjusted hazard ratio (aHR) = 0.24; 95% confidence interval (CI) = 0.07-0.80, <i>p</i> = .02), with a trend that persisted over 5 years. The TCM group's proteinuria was significantly lower than that of the non-TCM group at various time points post-index date, including 6 months (174.98 mg vs. 248.09 mg, <i>p</i> <.001), 1 year (161.05 mg vs. 303.03 mg, <i>p</i> <.001), 3 years (150.26 mg vs. 250 mg, <i>p</i> = .03), and 10 years (147.06 mg vs. 190.75 mg, <i>p</i> = .03). After adjusting for confounding covariates, TCM users had a significantly decreased risk of mortality (aHR = 0.70, 95% CI = 0.58-0.83).</p><p><strong>Conclusion: </strong>Integrating TCM with conventional treatment could lower risk of ESRD and mortality, highlighting the potential for a more holistic approach to patient care for SLE.</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"1-9"},"PeriodicalIF":2.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}