Treatment patterns in hyperlipidaemia patients based on administrative claim databases in Japan

Wake, Mayumi; Onishi, Yoshie; Guelfucci, F; Oh, Akinori; Hiroi, Shinzo; Shimasaki, Yukio; Teramoto, Tamio

doi:10.1016/j.atherosclerosis.2018.03.023

Cited by 26 publications

(24 citation statements)

References 30 publications

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“…However, a meta-analysis of population cohorts by KDIGO showed a linear relationship between lower eGFR level and risk of CV mortality; namely CKD patients with an eGFR level less than 15 mL/min/1.73 m 2 had the highest risk of CV mortality (HR, 3.14; 95% CI, 2.39-4.13) compared to eGFR 95 mL/min/1.73 m 2 (14). One possible explanation of the difference between previous studies and the present one is that patients who have any potential risks of CV diseases with a lower eGFR level might be transferred to other hospitals for dialysis treatment, and therefore information on events, particularly among the stratified group of eGFR < 15 mL/min/1.73 m 2 , could not be captured due to the characteristics of the MDV database (15).…”

Section: Discussioncontrasting

confidence: 58%

A retrospective cohort study of clinical characteristics, treatment patterns, and disease outcomes of chronic kidney disease in patients with diabetes using a Japanese claims database

Yamazaki

Yoshihara

et al. 2020

Preprint

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Objectives: The primary objective of this study was to characterize the clinical characteristics, treatment patterns, and clinical outcomes of chronic kidney disease (CKD) patients with diabetes, using a Japanese claims database and focusing on the use of mineralocorticoid receptor antagonists (MRAs) in this population in the real-world setting.Methods: This retrospective cohort study used the Medical Data Vision database, a large, electronic health records-based claims database in Japan. The observation period was a maximum of 8 years (from 1st April 2008 to 31st August 2016). The inclusion criteria were a claim with a diagnosis of diabetes (ICD-10: E10-E14), eGFR less than 60 mL/min/1.73 m2 at the index date, and use of any antiglycemic medications within 6 months prior to the index date or during the index month. Patients who had a claim for an MRA drug after the index date were identified as the MRA subcohort. This exploratory study investigated the burden of disease in patients with CKD and diabetes, including demographics, treatments, safety, and time-to-event analysis for renal and cardiovascular-related endpoints.Results: A total of 19,582 patients were included in the analysis, and 2,295 MRA patients were included in the subcohort. Renin-angiotensin-aldosterone system inhibitors were used at baseline by 52.3% in the overall cohort and 58.8% in the MRA subcohort. Cumulative incidences of hyperkalemia were 5.19% in the overall cohort and 7.63% in the MRA subcohort. Cox models showed that the 30–44 mL/min/1.73 m2 eGFR group had a significantly higher hazard of composite cardiovascular outcomes compared to the 45–59 mL/min/1.73 m2 group (HR, 1.22; 95% CI, 1.09–1.36).Conclusion: There are residual risks for hyperkalemia and renal and cardiovascular-related events in diabetic patients with CKD in the real-world setting in Japan, even after starting treatment with steroidal MRA drugs. The unmet needs and burden of disease should be considered in future treatments for CKD patients with diabetes.

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Section: Discussioncontrasting

confidence: 58%

A retrospective cohort study of clinical characteristics, treatment patterns, and disease outcomes of chronic kidney disease in patients with diabetes using a Japanese claims database

Yamazaki

Yoshihara

et al. 2020

Preprint

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“…This study is a retrospective observational analysis using de-identified, individual-level data obtained from the health claims database of the Japan Medical Data Center (JMDC), Tokyo, between 2005 and 2017. [11][12][13][14][15] This database contains medical claims data provided by multiple health insurance services for employees and their family members. Included are patient demographics, diagnosis codes recorded as standardized local codes of diseases defined by the Medical Information System Development Center mapped to the International Classification of Diseases (ICD)-10 codes, prescriptions, medical procedures and examinations.…”

Section: Study Design and Source Of Datamentioning

confidence: 99%

Lipid‐lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: A real‐world observational analysis of a health claims database

Kawasaki

Konta

Nishida

2018

Diabetes Obesity Metabolism

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“…Another reason would be statin intolerance. A recent report 15) analyzed administrative claim databases in Japan, and the results showed that more than 20% of patients discontinued their medication for dyslipidemia within one year after the initiation of medication; for high-dose statin therapy, that amount exceeded 60%. Statin intolerance, including the nocebo effect 16) , might somehow have contributed to this discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Association between Prescription and Control Status of Dyslipidemia and Hypertension among Japanese Patients with Diabetes

Sakamoto

Edo

Takahashi

et al. 2019

JAT

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Aims: The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.Methods: Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.Results: The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%–75% for LDL-C, and around 30%–40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.Conclusions: The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD.

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Treatment patterns in hyperlipidaemia patients based on administrative claim databases in Japan

Abstract: Most common prescriptions were moderate statins in UT patients and combination therapy in PT patients. The high discontinuation rate of HLD therapy in UT patients warrants further investigation and identification of methods to encourage and support long-term persistence.

Cited by 26 publications

References 30 publications

A retrospective cohort study of clinical characteristics, treatment patterns, and disease outcomes of chronic kidney disease in patients with diabetes using a Japanese claims database

A retrospective cohort study of clinical characteristics, treatment patterns, and disease outcomes of chronic kidney disease in patients with diabetes using a Japanese claims database

Lipid‐lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: A real‐world observational analysis of a health claims database

Association between Prescription and Control Status of Dyslipidemia and Hypertension among Japanese Patients with Diabetes

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