日本肺动脉高压患者内皮素受体拮抗剂治疗持久性和依从性的比较:一项真实世界的行政索赔数据库研究。

IF 2.3 Q2 RESPIRATORY SYSTEM

Pulmonary Therapy Pub Date : 2023-12-01 Epub Date: 2023-11-22 DOI:10.1007/s41030-023-00244-w

Junichi Omura, Yogeshwar Makanji, Nobuhiro Tanabe, Dae Young Yu, Jin Yu Tan, Sooyeol Lim, Mahsa H Kouhkamari, Jeremy Casorso, David Bin-Chia Wu, Paul Bloomfield

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引用次数: 0

摘要

引言:内皮素受体拮抗剂(ERAs;特别是在亚洲国家，用于肺动脉高压(PAH)的马伐他坦，波生坦，安布里森坦(ambristan)非常稀缺。我们在日本(2015年)批准马西坦前后评估了这些era的持久性。方法:我们使用2008年4月至2020年11月日本医疗数据视觉管理索赔数据库中的真实数据。从数据集中确定了多环芳烃患者。在日本，马西坦获批前后对ERA治疗的持续时间定义为开始指标ERA到停止治疗或死亡之间的时间。倾向评分调整用于减少治疗组间的混杂效应。结果:在马西坦批准前队列中，分别有153名和51名患者接受了波生坦和安布里森坦。在马张坦批准后的队列中，分别有331,284和91名患者接受了马张坦，波生坦和安布里森坦。安布里森坦和波生坦治疗的患者未调整的中位持续时间分别为19个月和10个月(调整后HR 0.87 [95% CI 0.61-1.24];P = 0.434[波生坦为参考])。在马西坦批准后的队列中，马西坦治疗的患者未调整的中位持续时间为18个月，而安布里森坦和波生坦治疗的患者分别为6个月和8个月。安布里森坦和波生坦的调整后hr为1.48 (95% CI 1.12-1.95;P = 0.006)和1.63 (95% CI 1.30-2.04;结论:日本PAH患者的真实数据显示，自批准以来，与ambrisentan和bosentan相比，macitentan的持久性明显更高。

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Comparative Treatment Persistence and Adherence to Endothelin Receptor Antagonists Among Patients with Pulmonary Arterial Hypertension in Japan: A Real-World Administrative Claims Database Study.

Introduction: Real-world data on the comparative effectiveness of endothelin receptor antagonists (ERAs; macitentan, bosentan, ambrisentan) for pulmonary arterial hypertension (PAH), particularly in Asian countries, are scarce. We evaluated the persistence of these ERAs before and after macitentan approval in Japan (2015).

Methods: We used real-world data from the Japanese Medical Data Vision administrative claims database between April 2008 and November 2020. Patients with PAH were identified from the dataset. Persistence to ERA treatment before and after approval of macitentan in Japan was defined as the time between start of the index ERA and treatment discontinuation or death. Propensity score adjustment was applied to minimize confounding effects among treatment groups.

Results: In the pre-macitentan approval cohort, 153 and 51 patients received bosentan and ambrisentan, respectively. In the post-macitentan approval cohort, 331, 284, and 91 patients received macitentan, bosentan, and ambrisentan, respectively. Unadjusted median persistence for ambrisentan- and bosentan-treated patients was 19 and 10 months, respectively (adjusted HR 0.87 [95% CI 0.61-1.24]; P = 0.434 [bosentan as reference]). In the post-macitentan approval cohort, unadjusted median persistence was 18 months for macitentan-treated patients versus 6 and 8 months for ambrisentan- and bosentan-treated patients, respectively. Adjusted HRs for ambrisentan and bosentan were 1.48 (95% CI 1.12-1.95; P = 0.006) and 1.63 (95% CI 1.30-2.04; P < 0.001 [macitentan as reference]), respectively.

Conclusions: Real-world data for Japanese patients with PAH showed that persistence was significantly higher for macitentan, versus ambrisentan and bosentan, since its approval.

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来源期刊

Pulmonary Therapy Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Pulmonary Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the use of pulmonary therapies, devices, and surgical techniques. Areas of focus include, but are not limited to: asthma; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; pulmonary hypertension; cystic fibrosis; lung cancer; respiratory tract disorders; allergic rhinitis and other respiratory allergies; influenza, pneumococcal infection, respiratory syncytial virus and other respiratory infections; and inhalers and other device therapies. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Pulmonary Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of pulmonary therapies. Open Access All articles published by Pulmonary Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. 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