Preventive medicine最新文献

{"title":"Joint association of diet quality and physical activity with obstructive sleep apnea: A cross-sectional study","authors":"Wenwei Zuo ,&nbsp;Xuelian Yang","doi":"10.1016/j.ypmed.2025.108226","DOIUrl":"10.1016/j.ypmed.2025.108226","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the relationship between the independent effects of dietary quality (DQ) (Healthy Eating Index [HEI]-2015) and physical activity (PA) and their joint effects and the risk of obstructive sleep apnea (OSA).</div></div><div><h3>Methods</h3><div>This cross-sectional study collected information on participants with complete DQ, PA, and OSA diagnostic data from the 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). We used multivariate logistic regression modeling to explore the relationship between the independent and joint effects of DQ and PA and OSA. In addition, sensitivity analyses were conducted to further validate the robustness of the results.</div></div><div><h3>Results</h3><div>A total of 8050 participants were included in this study, 3930 males and 4120 females. After adjusting for confounders, qualified DQ and high-level PA were significantly associated with a lower risk of OSA, with an odd ratio (OR) of 0.860 (95 % CI: 0.759–0.974) and 0.849 (95 % CI: 0.751–0.961), respectively. In the combined analysis, qualified DQ and high-level PA significantly reduced the risk of OSA (OR: 0.705, 95 % CI: 0.591–0.842). The sensitivity analysis results were consistent with the original results, further validating our findings.</div></div><div><h3>Conclusions</h3><div>The results of this study demonstrated that the combination of qualified DQ and high-level PA was significantly associated with a reduced risk of OSA. This finding emphasized the importance of a healthy lifestyle in the prevention of OSA.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"192 ","pages":"Article 108226"},"PeriodicalIF":4.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender identity and activity limitations: A national study on transgender and non-binary Canadians","authors":"Yihong Bai ,&nbsp;Peiya Cao ,&nbsp;Chungah Kim ,&nbsp;Kristine Ienciu ,&nbsp;Inthuja Selvaratnam ,&nbsp;Alex Abramovich ,&nbsp;Brittany Jakubiec ,&nbsp;David J. Brennan ,&nbsp;Antony Chum","doi":"10.1016/j.ypmed.2025.108224","DOIUrl":"10.1016/j.ypmed.2025.108224","url":null,"abstract":"<div><h3>Introduction</h3><div>Activity limitations among transgender and non-binary individuals remain largely unexplored using population-based samples. This study examines the risk of activity limitations across different gender identities in Canada.</div></div><div><h3>Method</h3><div>Using data from the 2021 Canadian long-form Census, logistic regressions estimated the adjusted odds of reporting activity limitations (seeing, hearing, mobility/dexterity, mental, cognitive, and other) across gender identities.</div></div><div><h3>Results</h3><div>Non-binary individuals assigned female at birth (AFAB) had the highest predicted probability of reporting any activity limitations (76.13 %), followed by non-binary individuals assigned male at birth (AMAB) at 61.56 %, transgender men (44.71 %), and transgender women (34.41 %). Cisgender men (19.31 %) and cisgender women (21.98 %) had the lowest probabilities. Mental limitations showed the largest disparity, with 39.4 % of non-binary AFAB individuals affected, compared to 4.9 % of cisgender men. These findings highlight significant disparities in activity limitations across gender identities.</div></div><div><h3>Conclusion</h3><div>Non-binary and transgender individuals are most at risk for activity limitations. These findings underscore the need for targeted policies to address challenges faced by gender-diverse populations. Future research should investigate the mechanisms behind these disparities. Healthcare policies must prioritize culturally competent, transgender-inclusive care to reduce disparities in activity limitations.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"192 ","pages":"Article 108224"},"PeriodicalIF":4.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated lipid accumulation product trajectory patterns are associated with increasing incident risk of type 2 diabetes mellitus in China","authors":"Yuying Wu ,&nbsp;Yanyan Zhang ,&nbsp;Yang Zhao ,&nbsp;Xing Zhang ,&nbsp;Minqi Gu ,&nbsp;Weifeng Huo ,&nbsp;Xueru Fu ,&nbsp;Xi Li ,&nbsp;Botang Guo ,&nbsp;Jianxin Li ,&nbsp;Xiangfeng Lu ,&nbsp;Fulan Hu ,&nbsp;Dongsheng Hu ,&nbsp;Ming Zhang","doi":"10.1016/j.ypmed.2024.108186","DOIUrl":"10.1016/j.ypmed.2024.108186","url":null,"abstract":"<div><h3>Purpose</h3><div>Our study aimed to identify the trajectory patterns of lipid accumulation product (LAP) and investigate their association with the incident risk of type 2 diabetes mellitus (T2DM) in China.</div></div><div><h3>Methods</h3><div>This study included 37,316 eligible participants, with data collected between1998 and 2021. The LAP trajectory patterns were identified through latent mixture modeling. Logistic regression models were used to examine the association between different LAP trajectory patterns and the incident risk of T2DM.</div></div><div><h3>Results</h3><div>Over an average period of 12.7 years, 3195 participants developed T2DM. Four LAP trajectory patterns were identified: low stable, moderate slow-increasing, high decreasing, and moderate fast-increasing. After adjusting for demographic and clinical confounders, the odds ratios (ORs) and 95 % confidence intervals (CIs) for T2DM were 1.67 (1.50, 1.86) for the moderate slow-increasing group, 1.63 (1.38, 1.94) for the high decreasing group, and 2.43 (2.07, 2.85) for the moderate fast-increasing group compared with the low stable group. Similar trajectory patterns were found in sex-specific populations as in the general population, while the elevated LAP trajectory pattern was more strongly associated with an increase in the incident risk of T2DM in females.</div></div><div><h3>Conclusion</h3><div>Individuals with moderate fast-increasing LAP trajectory patterns had a 2.4 times higher risk of developing T2DM compared to those with low stable LAP patterns. More attention should be paid to preventing T2DM in people with high levels of LAP, especially females, the elderly, drinkers, and people with a history of diabetes.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108186"},"PeriodicalIF":4.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procrastination and preventive health-care in the older U.S. population","authors":"Cormac Monaghan ,&nbsp;Rafael de Andrade Moral ,&nbsp;Joanna McHugh Power","doi":"10.1016/j.ypmed.2024.108185","DOIUrl":"10.1016/j.ypmed.2024.108185","url":null,"abstract":"<div><h3>Objective</h3><div>Maintaining health preventive behaviours in later life reduces the risk of non-communicable diseases. However, these behaviours often require effort and discipline to adopt and may be prone to procrastination. This study examined whether procrastination affected engagement in health preventive behaviours among older adults.</div></div><div><h3>Methods</h3><div>We applied generalised additive models to data from the 2020 wave of the United States Health and Retirement Study. Our analytic sample consisted of adults aged 50+ (<em>n</em> = 1338; mean = 68.24; range = 50–95). Our analysis focused on six health preventive behaviours: prostate exams, mammograms, cholesterol screenings, pap smears, flu shots, and dental visits.</div></div><div><h3>Results</h3><div>Procrastination was associated with less frequent engagement in mammograms and cholesterol screenings among women, though it had no significant association with pap smears or flu shots. Additionally, procrastination interacted with depression reducing the likelihood of prostate exams in men and dental visits in both men and women, such that individuals with high procrastination and low depression were associated with less frequent engagement in both preventive health behaviours.</div></div><div><h3>Conclusions</h3><div>Procrastination may be a behavioral risk factor for maintaining optimal health in older adults. Given that procrastination is a potentially modifiable behaviour, interventions aimed at reducing procrastination, such as simplifying tasks or providing default appointment, could improve engagement in critical health preventive behaviours.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108185"},"PeriodicalIF":4.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of children's electronic media use with physical activity, cognitive function, and stress","authors":"Deborah A. Cohen ,&nbsp;Robert Zarr ,&nbsp;Erika Estrada ,&nbsp;Haoyuan Zhong ,&nbsp;Bing Han","doi":"10.1016/j.ypmed.2024.108184","DOIUrl":"10.1016/j.ypmed.2024.108184","url":null,"abstract":"<div><h3>Objective</h3><div>Electronic media is constantly evolving and has become an integral part of people's lives, especially among youth. This cross-sectional observational study assessed the association between electronic media use, health behaviors and outcomes, specifically, physical activity, stress and cognitive function among youth from an under-resourced community.</div></div><div><h3>Methods</h3><div>Participants ages six-sixteen were recruited from a Federally Qualified Health Center to participate in a study to promote park prescriptions with data collection between 2020 and 2024. At baseline, both intervention and control participants were asked to wear an accelerometer for one week and complete surveys about their electronic media time, stress, and cognitive function. We estimated the associations between electronic media use and health outcomes using cross-sectional multiple regressions.</div></div><div><h3>Results</h3><div>Among the 441 participants, the average amount of electronic media use was 48.6 h per week (95 % CI: 46.0, 51.1), with children ages 6–9 engaging in 37.3 h per week (95 % CI: 34.5, 40.2) and youth ages 10–16 engaging in 56.4 h per week of electronic media time (95 % CI: 52.9, 59.9). Average daily MVPA was 16.6 min (95 % CI: 15.4, 17.8). Electronic media use time was negatively associated with MVPA and with cognitive function for all age groups. Electronic media time was only associated with stress for youth over age 10.</div></div><div><h3>Conclusion</h3><div>The associations among electronic media, MVPA, cognitive function and stress were statistically significant, but relatively modest. Future research should examine whether reducing time on electronic media will have a positive impact on physical activity and mental health outcomes.</div><div><strong>Clinical trials registry number:</strong> #NCT04114734.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108184"},"PeriodicalIF":4.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Firearm possession among emergency department youth and young adults: A latent class analysis","authors":"Heather A. Hartman ,&nbsp;Laura A. Seewald ,&nbsp;Philip Stallworth ,&nbsp;Daniel B. Lee ,&nbsp;Marc A. Zimmerman ,&nbsp;Peter F. Ehrlich ,&nbsp;Maureen A. Walton ,&nbsp;Kenneth Resnicow ,&nbsp;Patrick M. Carter","doi":"10.1016/j.ypmed.2024.108183","DOIUrl":"10.1016/j.ypmed.2024.108183","url":null,"abstract":"<div><h3>Introduction</h3><div>Firearm injuries are a leading cause of death for youth/young-adults. We utilized latent class analysis to identify distinct motivational/behavioral patterns of firearm possession in a youth/young-adult emergency department sample to inform prevention strategies.</div></div><div><h3>Methods</h3><div>Cross-sectional data were obtained from surveys conducted among youth/young-adults (age = 16–29; <em>n</em> = 1311) seeking emergency department treatment (7/10/2017–6/25/2018). Latent class analysis was performed for individuals reporting firearm possession (<em>n</em> = 223) using five variables: carriage frequency, social carriage, risky firearm behaviors, ownership/carriage for protection, and recreational ownership/carriage. Descriptive statistics were examined.</div></div><div><h3>Results</h3><div>In this sample, 17.0 % reported having firearms (age-22.7; 48.0 %-male; 49.3 %-Black; 52.5 %-public assistance). Latent class analysis identified four classes: 1-recreational possession (<em>n</em> = 51); 2-possession for protection with low carriage (<em>n</em> = 60); 3-carriage for protection with low risky firearm behaviors (<em>n</em> = 76); and 4-carriage for protection with high risky firearm behaviors (<em>n</em> = 36). Class-1 (recreational possession) had low firearm victimization, violence exposure, and community violence. This class primarily kept long-guns with secure storage patterns. Class-2 (protection with low carriage) were mostly female youth/young-adults with children and reported moderately high rates of violence exposure. Nearly 20 % stored their firearm unlocked. Class-3 and -4 endorsed firearm carriage for protection, with Class-4 also engaging in risky firearm behaviors. Both classes had high violence exposure; however, Class-4 had higher risk profiles including higher marijuana misuse, mental health symptoms, and firearm victimization.</div></div><div><h3>Conclusions</h3><div>Among an emergency department sample, four distinct firearm possession classes emerged with different risk levels. Understanding firearm behaviors and risk/protective factors is critical to tailoring healthcare-focused interventions to address individual needs and reduce injury risk.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108183"},"PeriodicalIF":4.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related social needs screening, reporting, and assistance in a large health system","authors":"Elyse N. Llamocca ,&nbsp;Andrew S. Bossick ,&nbsp;Denise White Perkins ,&nbsp;Brian K. Ahmedani ,&nbsp;Rob Behrendt ,&nbsp;Anna Bloemen ,&nbsp;Angela Murphy ,&nbsp;Aishwarya Kulkarni ,&nbsp;Elizabeth Lockhart","doi":"10.1016/j.ypmed.2024.108182","DOIUrl":"10.1016/j.ypmed.2024.108182","url":null,"abstract":"<div><h3>Background</h3><div>National mandates require screening for and addressing health-related social needs (HRSNs) in healthcare settings. However, differences in HRSN screening process (i.e., completed screenings, screening results, documented offer of assistance, documented assistance request) have been reported by population subgroup. Knowledge of the most effective HRSN screening and intervention methods is limited. We sought to describe differences in completed HRSN screenings, screening results, and assistance request rates across patient and healthcare visit characteristics.</div></div><div><h3>Methods</h3><div>We examined data from all patients aged ≥18 years and residing in the US receiving services at a large, Midwestern healthcare system with a goal to screen all patients for HRSN at least once annually between July 2021–June 2023 (<em>n</em> = 1,190,488). We examined the proportion of patients with any HRSN screening, with any reported HRSN, asked whether they wanted assistance, or who requested assistance for a reported HRSN stratified by patient demographics and healthcare visit characteristics (i.e., payer, screening location, who completed the screening).</div></div><div><h3>Results</h3><div>Less than half of eligible patients (47.0 %) were screened for HRSNs. About one-sixth (16.9 %) reported any HRSN. Although most patients reporting HRSNs were asked whether they wanted assistance, only about one-quarter (26.8 %) responded affirmatively. Proportions included in each step of the HRSN screening process significantly differed by patient and healthcare visit characteristics.</div></div><div><h3>Discussion</h3><div>This study is one of the first to investigate various steps of a population-wide HRSN screening program. Our findings suggest that examining differences in HRSN screening process by population subgroup is key to addressing HRSNs through a health equity lens.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108182"},"PeriodicalIF":4.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure and cardiomyopathy mortality trends and disparities among obese populations: A 20-year United States study","authors":"Yong-Hao Yeo ,&nbsp;Boon-Jian San ,&nbsp;Ela Ahmad ,&nbsp;Min-Choon Tan ,&nbsp;Yuh-Miin Sin ,&nbsp;Milena Jani ,&nbsp;Richard J. Bloomingdale","doi":"10.1016/j.ypmed.2024.108179","DOIUrl":"10.1016/j.ypmed.2024.108179","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to assess the heart failure/cardiomyopathy-related population-level mortality trends among patients with obesity in the United States and disparities across demographics.</div></div><div><h3>Methods</h3><div>We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database among adults aged ≥25 from 1999 to 2019. Heart failure/cardiomyopathy were listed as the main causes of death, with obesity as a contributing cause. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and estimated the average annual percent change (AAPC). We also evaluated the social vulnerability of United States counties (2014–2018).</div></div><div><h3>Results</h3><div>There were 29,334 deaths related to heart failure/cardiomyopathy among patients with comorbid obesity. The overall AAMR increased from 0.41 in 1999 to 0.94 in 2019, with an AAPC of 3.78 (95 % CI, 3.41–4.14). The crude mortality rate increase for heart failure/cardiomyopathy was greater in individuals with comorbid obesity than in those without. Males had a higher AAMR than females (0.78 vs 0.55). African Americans also had higher AAMR than Whites (1.35 vs 0.62). The AAMR was higher in rural areas than in urban regions (0.76 vs 0.66). The overall AAMR was higher in counties with social vulnerability index-Quartile 4 (SVI-Q4) (most vulnerable) (1.08) compared to SVI-Q1 (least vulnerable) (0.63) with a risk ratio of 1.71 (95 % CI: 1.61–1.83).</div></div><div><h3>Conclusion</h3><div>Heart failure/cardiomyopathy mortality in individuals with comorbid obesity was rising. Males, African Americans, and individuals from rural regions had higher AAMR than their counterparts.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108179"},"PeriodicalIF":4.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific associations of cigarettes and e-cigarettes use with self-reported premature atherosclerotic cardiovascular disease among adults aged 18–54 in the United States","authors":"Ememgini Elo-Eghosa ,&nbsp;Wei Li ,&nbsp;Mohammad Ebrahimi Kalan ,&nbsp;Nan Hu ,&nbsp;Olatokunbo Osibogun","doi":"10.1016/j.ypmed.2024.108181","DOIUrl":"10.1016/j.ypmed.2024.108181","url":null,"abstract":"<div><h3>Background</h3><div>Premature atherosclerotic cardiovascular disease (ASCVD) is increasing in young adults (&lt;55 years old). While research suggests females who smoke cigarettes have a higher risk of ASCVD than males, studies on the impact of exclusive e-cigarette and dual use on premature ASCVD are limited. This study investigated the association between tobacco use and self-reported premature ASCVD and explored potential sex differences.</div></div><div><h3>Methods</h3><div>Using pooled data from 480,317 adults (ages 18–54; ∼50 % female) from the 2020–2022 Behavioral Risk Factor Surveillance System from the United States, logistic regression models assessed associations between cigarette and e-cigarette use patterns and self-reported premature ASCVD. Tobacco use categories were defined as: non-use, former use (cigarettes, e-cigarettes), and current use (cigarettes, e-cigarettes) and dual use. Self-reported premature ASCVD was defined as self-reported angina or coronary heart disease, heart attack, or stroke. Weighted analyses were conducted for the overall sample and stratified by sex.</div></div><div><h3>Results</h3><div>After controlling for potential confounders, former exclusive cigarette (adjusted OR: 1.47 [95 % CI 1.29, 1.67]), current exclusive cigarette (1.68 [1.47–1.94]) and current dual (2.03 [1.69–2.44]) use were associated with higher odds of self-reported premature ASCVD. There was no significant association for e-cigarette use. Sex-specific analyses revealed similar patterns but the magnitude of these associations varied between males and females.</div></div><div><h3>Conclusion</h3><div>Both sexes showed higher odds of self-reported premature ASCVD for dual and exclusive cigarette use. Although the cross-sectional design precludes causal inferences, the findings suggest comprehensive tobacco cessation programs tailored to diverse use patterns are needed to reduce the burden of premature ASCVD.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108181"},"PeriodicalIF":4.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of high-efficacy and moderate efficacy disease-modifying agents in reducing the annualized relapse rates among multiple sclerosis patients in the United States","authors":"Jieni Li ,&nbsp;George J. Hutton ,&nbsp;Tyler J. Varisco ,&nbsp;Ying Lin ,&nbsp;Ekere J. Essien ,&nbsp;Rajender R. Aparasu","doi":"10.1016/j.ypmed.2024.108180","DOIUrl":"10.1016/j.ypmed.2024.108180","url":null,"abstract":"<div><h3>Objective</h3><div>The optimal treatment strategy for the management of multiple sclerosis is widely discussed due to the increasing availability of high-efficacy disease-modifying agents (heDMAs). This study evaluated the comparative effectiveness of heDMA and moderate-efficacy disease-modifying agents (meDMAs) use in reducing annualized relapse rate (ARR) among multiple sclerosis patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the 2015–2019 United States Merative MarketScan Commercial Claims Data. Adult (18–64 years) patients with incident disease-modifying agents (DMA) use were included. Claim-based relapse algorithms were applied to measure relapse events. The inverse probability treatment weighting (IPTW) based negative binomial regression model with the offset of the follow-up period was used to compare the ARR. The moderation effect of sex on ARR was also examined.</div></div><div><h3>Results</h3><div>This study included 10,003 incident DMA users, with 22.9 % initiated heDMAs. The average ARR during follow-up among heDMA users was lower than meDMA users (0.25 vs. 0.28, <em>p</em> &lt; 0.01). The IPTW-based regression found that sex moderated the relationship between the types of DMAs and ARR. Stratified analyses revealed that heDMAs were associated with a lower ARR in males (adjusted incidence rate ratio [aIRR] 0.74; 95 % confidence interval [CI] 0.59–0.94) compared with meDMAs. No significant differences were noted among females (aIRR 0.99; 95 % CI: 0.88–1.21).</div></div><div><h3>Conclusion</h3><div>The study found that sex moderated the effect of heDMAs, with male multiple sclerosis patients using heDMAs associated with a 26 % decreased risk of relapse than those with meDMAs. However, there was no difference in comparative effectiveness for females.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"190 ","pages":"Article 108180"},"PeriodicalIF":4.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}