The Chang Gung Research Database—A multi‐institutional electronic medical records database for real‐world epidemiological studies in Taiwan

Lin

et al. 2020

Sci Rep

We evaluated the efficacy of second-line hormonal therapy for treatment of metastatic castrationresistant prostate cancer (mcRpc) in a real-world retrospective study. We conducted a populationbased real-world cohort study of 258 mCRPC patients between 2014 and 2018 using the Chang Gung Research Database (CGRD) of Taiwan. The second-line hormonal therapy included abiraterone acetate and enzalutamide. The clinical efficacy outcomes were overall survival (OS) and prostate-specific antigen (PSA) doubling time. The median PSA level was also assessed. In total, 223 mCRPC patients who underwent second-line hormonal therapy met all of the inclusion and exclusion criteria for this study. Among them, 65 (29.1%) patients were in the PSA response group and 158 (70.9%) were in the non-response group. The median age was 72.9 years. The median OS was 12.3 months (range: 9.9-19.9 months) and 9.6 months (range: 5.3-15.9 months) in the response and non-response groups, respectively, and the respective PSA doubling times were 9.0 months (range: 4.4-11.6 months) and 3.9 months (range: 2.2-9.1 months), with a median follow-up period of 10.5 months. A significantly longer median oS was seen in the pSA response group. this real-world database study demonstrated that clinical outcomes of second-line hormonal therapy were better in patients with a pSA response. further studies are warranted to achieve a better understanding of second-line hormonal therapy for mcRpc in Asian populations.Androgen deprivation therapy (ADT) has been a mainstay of treatment for advanced prostate cancer (PCa) 1 . Eventually, patients with PCa will progress to castration-resistant prostate cancer (CRPC). In recent years, second-line hormonal therapies for metastatic CRPC (mCRPC) have become available, including abiraterone acetate (AA) and enzalutamide 2,3 . Both of them prolonged overall survival in patients with mCRPC who had disease progression.A randomized double-blind controlled study (COU-AA-301) of metastatic CRPC patients post-chemotherapy showed that AA therapy significantly increased overall survival (OS) and radiographic progression-free survival (rPFS) in comparison to placebo 2 . The COU-AA-302 trial also showed that AA increased OS and rPFS in metastatic CRPC patients pre-chemotherapy 4 . Meanwhile, the AFFIRM and PREVAIL studies showed that enzalutamide had significant benefits on OS and rPFS in metastatic CRPC patients, both post-and pre-chemotherapy 3,5 . AA and enzalutamide for treatment of metastatic CRPC have been approved by the Taiwan Food and Drug

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Second-line Hormonal Therapy for the Management of Metastatic Castration-resistant Prostate Cancer: a Real-World Data Study Using a Claims Database

Lin

et al. 2020

Sci Rep

Diabetes Obesity Metabolism

“…The CGRD is the largest multi‐institutional electronic medical records database in Taiwan, covering 1.3 million individuals from seven hospitals (6% of the Taiwan population). The structure of the CGRD has been described elsewhere . Compared to primary data collections, secondary data sources, such as the CGRD, can provide efficient and timely evaluations of treatment outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…The structure of the CGRD has been described elsewhere. 5 Compared to primary data collections, secondary data sources, such as the CGRD, can provide efficient and timely evaluations of treatment outcomes.…”

Section: Study Design and Settingsmentioning

confidence: 99%

Effects of sodium‐glucose co‐transporter‐2 inhibitors on serum alanine aminotransferase levels in people with type 2 diabetes: A multi‐institutional cohort study

Shao

Chang

Chien

et al. 2019

Self Cite

Clinical trials have indicated that sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors have a favourable effect on serum alanine aminotransferase (ALT) levels in people with type 2 diabetes (T2D), but supporting evidence from real‐world studies is lacking. We identified patients with T2D who initiated SGLT2 inhibitors during the period 2016 to 2017 from Chang Gung Research Database, which covers 1.3 million individuals from seven hospitals (6% of the Taiwan population). We classified patients by baseline ALT level and evaluated changes in ALT values from baseline to 1 year after initiation of SGLT2 inhibitors. We identified 11 690 new users of SGLT2 inhibitors with a mean (SD) age of 59.3 (11.8) years. The mean (SD) glycated haemoglobin and ALT levels were 8.9 (1.7)% and 34.7 (28.9) U/L at baseline, respectively. The mean change in ALT levels was −5.0 U/L (95% confidence interval [CI] –6.4, −3.5) 1 year after initiation of SGLT2 inhibitors. In patients with ALT levels ≤1× the upper limit of normal (ULN), the change in ALT levels was 1.6 U/L (95% CI –0.1, 3.4), while in those with ALT levels >1× ULN, the change in ALT levels was −26.5 U/L (95% CI –28.6, −24.3). The higher the baseline ALT level, the greater the decline after SGLT2 inhibitor treatment. Our findings suggest the initiation of SGLT2 inhibitors for T2D management could improve serum ALT levels in clinical practice, particularly in patients with especially high ALT levels.

“…The data in the CGRD include demographic data, inpatient and outpatient data, diagnostic codes, details of prescriptions and reports of microbiological, image and functional examinations [15]. More detailed information about CGRD had been reported in a previous article [16].…”

Section: Data Sourcementioning

confidence: 99%

Etiology and characteristics of patients with bronchiectasis in Taiwan: a cohort study from 2002 to 2016

Huang

Chung

et al. 2020

BMC Pulm Med

Background: Bronchiectasis is a chronic infectious respiratory disease with diverse causes and ethnic or geographic differences. However, few large-scale studies of its etiology have been conducted in Asia. This study aimed to determine the etiology and clinical features of bronchiectasis in Taiwan.Methods: This longitudinal cohort study investigated the etiology and clinical features of newly diagnosed noncystic fibrosis bronchiectasis patients from January 2002 to December 2016. The clinical, functional and microbiological data of patients were retrieved from the Chang Gung Research Database, which includes seven medical facilities throughout Taiwan. The index date was the date of the first bronchiectasis diagnosis. Known diseases that were diagnosed before the index date were regarded as etiologies of bronchiectasis. Results: The cohort comprised 15,729 adult patients with bronchiectasis. Idiopathic (32%) was the most common cause, followed by post-pneumonia (24%). Other causes included post-tuberculosis (12%), chronic obstructive pulmonary disease (14%), asthma (10%), gastroesophageal reflux disease (2%) and rheumatic diseases (2%). At diagnosis, 8487 patients had sputum culture. Pseudomonas aeruginosa (5.3%) was the most common bacteria, followed by non-tuberculosis mycobacteria (3.6%), Haemophilus influenzae (3.4%) and Klebsiella pneumoniae (3.1%), but 6155 (72.1%) had negative sputum cultures. Patients with post-tuberculosis had a higher sputum isolation rate of non-tuberculosis mycobacteria than P. aeruginosa. Patients with post-tuberculosis and post-pneumonia bronchiectasis had a higher frequency of chronic lung infection than other groups (p < 0.05). Clinical characteristics, such as gender, lung function, comorbidities and microbiology, were significantly different between idiopathic and known etiologies.Conclusions: Idiopathic, post-infection and tuberculosis constitute major bronchiectasis etiologies in Taiwan. Clinical characteristics and sputum microbiology were distinct among separate etiology phenotypes.