| Project/Area Number |
17K08963
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Applied pharmacology
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| Research Institution | Meiji Pharmaceutical University (2020)
Tokyo Women's Medical University (2017-2019) |
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Principal Investigator |
Sakai Ryoko 明治薬科大学, 薬学部, 准教授 (30631981)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 関節リウマチ / 分子標的薬 / 安全性 / リスク / コホート研究 / 薬剤疫学 |
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| Outline of Final Research Achievements |
In this study, first, using National Data Base provided by Ministry of Health, Labour and Welfare in Japan, we showed the prevalence of methotrexate decreased with increasing age, whereas, that of biological DMARDs was similar in patients >65 years old. The prevalence of oral CS increased with increasing age. This study revealed nationwide prescription patterns of medications in elderly RA patients for the first time in Japan. Second, we compared the risk of hospitalized infection (HI) between methotrexate and targeted therapy in each age-group (young, 16-64 years old, elderly, 65-74 years old, and older elderly 75-years old) using claims data in Japan provided by Medical Data Vision Co., Ltd. The elderly and older elderly patients had significantly higher risks of HI compared to the young. The risk of HI under the TT compared to MTX was decreased in the elderly patients, probably due to adjusting for treatment by attending physicians.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究で使用したNDBは我が国の最大規模のレセプトデータであることから通常の観察研究でしばしば問題となる選択バイアスの影響が極めて少ないデータソースである。本研究結果は日本全体におけるRAの診療実態を詳細に記述した初めての成果であり、我が国のRA診療ガイドラインの改定（関節リウマチ診療ガイドライン2020 診断と治療社2021年4月26日初版第1刷発行）に有用なエビデンスの一部となった。また、大規模レセプトデータを使った研究成果は高齢RA患者に適切な薬物治療を選択する上で重要なエビデンスとなり、安全な薬物治療の提供に繋がることが期待される。
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