The number of elderly patients with hematologic malignancies has been steadily increasing with the aging of society. However, little research has been conducted to evaluate the prescription status of drugs for such diseases in Japan. Therefore, the aims of this study were to identify the patient population currently being prescribed drugs for hematologic malignancies in Japan and the direction of drug development. To examine the prescription pattern of drugs for the treatment of hematological malignancies in Japan from 2010-2014, we used the IMS Japan Pharmaceutical Market database and the Japanese Society of Hematology Clinical Practice Guidelines, and for drug development status, we used ClinicalTrials.gov and the University Hospital Medical Information Network Clinical Trials Registry. We found a significant upward trend in prescriptions for molecular-targeted agents, which are typically prescribed over the long term, and a significant downward trend in chemotherapeutic agents, which are usually prescribed for the short term. We also found that recent drug development in hematological malignancies has focused on molecular-targeted agents. These results suggest that drug development should be directed toward anti-tumor agents in hematological malignancies that can help maintain and improve patients' QOL.

As drug price revision policy is under reconstruction in Japan, the characteristics of drugs targeted for price cutting shown in this study should be considered for establishing drug price revision policies that reflect market conditions adequately.

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Background: Acute kidney injury (AKI) often develops during the administration of liposomal amphotericin B (L-AMB), a broad-spectrum antifungal drug. However, clinical recovery approaches for AKI patients administered L-AMB have not been well established.Methods: A retrospective analysis was conducted using data obtained from hospitals throughout Japan. AKI was defined as a ≥1.5-fold increase within 7 days or ≥0.3 mg/dL increase within 2 days in serum creatinine. Renal recovery was defined as a return to creatinine levels below those recorded before the onset of AKI.Results: Herein, 189 patients had developed AKI following L-AMB administration. Of them, 153 were subsequently assessed to determine the trend in creatinine level after AKI and 90 patients were assessed for renal recovery. Patients administered ≥10 mL/kg daily fluid for 7 consecutive days from the onset of AKI had a 63% recovery rate relative to patients that did not receive infusion (35% recovery rate (P = 0.053)). Although extending the fluid infusion period beyond 7 days did not result in consistent improvement in renal recovery rates, daily fluid volume was found to be positively correlated with renal recovery (P = 0.043). On average, patients administered daily fluid infusions of ≥10 mL/kg had greater reductions in minimum creatinine levels for the first 7 days after AKI compared to patients that did not receive daily fluid infusions. After 7 days of fluid infusion, the mean minimum creatinine levels decreased by 0.21 mg/dL relative to 0.16 mg/dL for patients that did not receive daily fluid infusions.Conclusions: Seven consecutive days of daily fluid infusion from the onset of AKI may promote renal recovery from AKI in patients administered L-AMB, with daily fluid volume positively correlating with the incidence of renal recovery.