治疗模式和药物存活率对于泛性性牛皮:一个使用日本索赔数据库的患者旅程研究
Yayoi Tada1, Jia Guan2, Ryoko Iwasaki3
1Department of Dermatology, Teikyo University Hospital, Tokyo, Japan.
The Journal of dermatology
|January 12, 2024
概括
这项研究揭示了日本普遍性性牛皮 (GPP) 的现实世界治疗模式. 与非生物系统治疗相比,生物疗法显示药物存活时间更长,这表明GPP患者的长期治疗改善.
科学领域:
- 皮肤病学 皮肤病学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 泛性性牛皮 (GPP) 是一种严重的,可能危及生命的皮肤病.
- 关于日本GPP的治疗模式和药物存活率,现实世界数据有限.
- 经批准的GPP疗法需要了解当前的临床实践.
研究的目的:
- 描述日本新诊断的GPP患者的真实药物生存和治疗模式.
- 分析GPP治疗序列和治疗持续时间.
- 在不同的GPP治疗方式中比较药物存活率.
主要方法:
- 从2016年1月到2021年8月,使用非识别的日本索赔数据 (Medical Data Vision Co., Ltd.) 的回顾性队列研究.
- 纳入标准:新诊断的GPP (ICD-10代码L40.1) 随访时间≥1年.
- 分析一线,二线和三线治疗 (LOT) 的使用情况,到下一次治疗的时间 (TTNT) 和药物存活率.
主要成果:
- 分析了434名患有GPP的日本患者. 首线治疗包括乙烯酸 (26.4%),局部药物 (14.7%) 和环素 (14.3%).
- 在二线治疗中,生物药物 (IL-17,IL-23抑制剂) 和局部药物增加,而乙烯酸盐和环素减少.
- 生物药物显示较长的药物存活期 (例如,seukinumab:19.6个月) 与非生物系统药物相比 (例如,乙氨酸:8.8个月,全身皮质类固醇:4.3个月). 组合疗法比单一疗法有更长时间的TTNT.
结论:
- 在日本的现实世界GPP治疗模式涉及连续疗法,在后续线上大量使用生物药物.
- 与GPP管理的传统全身性药物相比,生物药物提供更高的药物存活率.
- 需要进一步开发治疗算法和耐受性良好,有效的GPP药物,以优化长期患者护理.
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