<p>Patterns of drug treatment in patients with osteoarthritis and chronic low back pain in Japan: a retrospective database study</p>

Abstract

Purpose: Musculoskeletal diseases, including osteoarthritis (OA) and low back pain (LBP), are the leading causes of years lived with disability, and are associated with lowered quality-of-life, lost productivity, and increased healthcare costs. However, information publicly available regarding the Japanese real-world usage of prescription medications is limited. This study aimed to describe the clinical characteristics of patients with OA and chronic LBP (CLBP), and to investigate the patterns of medications and opioid use in Japanese real-world settings. Materials and methods: A retrospective study was conducted using a Japanese administrative claims database between 2013 and 2017. The outcomes were patient characteristics and prescription medications, and they were evaluated separately for OA and CLBP. Results: The mean age of 118,996 patients with OA and 256,402 patients with CLBP was 68.8±13.1 years and 64.8±16.4 years, respectively. Approximately 90% of patients with OA and CLBP were prescribed non-steroidal anti-inflammatory drugs (NSAIDs). Other prescriptions included hyaluronate injection (35.6%), acetaminophen (21.4%), and steroid injection (20.0%) in patients with OA, and pregabalin (39.0%) and acetaminophen (22.4%) in patients with CLBP. Weak opioids were prescribed to 10.7% and 20.6% of patients with OA and CLBP, respectively. The prescription of COX-2 inhibitors (OA: +6.5%; CLBP: +6.7%) and acetaminophen (OA: +16.4%; CLBP: +14.4%) increased between 2013 and 2017. The first commonly prescribed medication among patients with OA and CLBP were NSAIDs; hyaluronate injection (patients with OA) and pregabalin (patients with CLBP) were also common first-line medications. Acetaminophen, steroid injection (patients with OA), and weak opioids were prescribed more in the later phases of treatment. Conclusion: Most patients were prescribed limited classes of pain drugs, with NSAIDs being the most common pain medication in Japan for patients with OA and CLBP. Opioid prescription was uncommon, and were weak opioids when prescribed.

Pain Pharmacotherapy in a Large Cohort of Patients with Osteoarthritis: A Real-World Data Analysis

“…In contrast, a recent publication from Belgium [22] reported that NSAIDs were prescribed to 29.4% of knee OA patients in 2015, a relatively similar rate to our observation in Israel. We found that 22.9% of OA patients used opioids, similar to the rates observed in Sweden (23.7%) [23] and the US (27%) [31], but higher than the 10% reported in Belgium [22] and Japan [18]. Paracetamol was used by approximately 20% of the OA patients in our study, a similar rate to Japan [18] and Belgium [22], but much higher than in Korea [21].…”

“…Despite the existence of several guidelines for the treatment of OA, the practical treatment of OA is not homogeneous in all countries. Our [18,21]. In contrast, a recent publication from Belgium [22] reported that NSAIDs were prescribed to 29.4% of knee OA patients in 2015, a relatively similar rate to our observation in Israel.…”

“…Pain is the most common symptom of OA [4,5] and leads to the use of analgesics [18][19][20][21][22][23]. Several recent treatment guidelines for pain due to OA are available [6,24,25] with a recommendation for the use of NSAIDs at an early treatment stage, when the use of other agents such as paracetamol and opioids is controversial.…”

Over-the-counter naproxen in rheumatology practice: scope and therapeutic benefits

“…М. Akazawa и соавт. [12], изучавшие применение обезболивающих средств у 118 996 пациентов с ОА с 2013 по 2017 г. по данным японского национального регистра, установили, что примерно 90% из них были назначены НПВП. С. Zeng и соавт.…”

Database Analysis on the Relationships Between Nonsteroidal Anti-inflammatory Drug Treatment Variables and Incidence of Acute Myocardial Infarction in Japanese Patients with Osteoarthritis and Chronic Low Back Pain

“…Surgical therapy, non-pharmacological therapy (exercise, gait aids, cognitive behavioral therapy, and self-management programs), and pharmacological therapy are available management options for treating pain associated with OA and CLBP [12][13][14][15]. An analysis using data from hospital-based administrative databases showed that approximately 90% of patients with chronic musculoskeletal pain were prescribed non-steroidal anti-inflammatory drugs (NSAIDs) in Japan [16]. Transdermal NSAID patches have demonstrated a superior safety profile over oral NSAIDs, and are recommended as first-line treatment for knee and hip OA by the Osteoarthritis Research Society International (OARSI) guidelines [13,14,[17][18][19].…”