Pharmacoepidemiological study to investigate the characteristics and treatments in patients with rheumatic diseases using a large health insurance database

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K10480
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Meiji Pharmaceutical University
• Principal Investigator: Sakai Ryoko 明治薬科大学, 薬学部, 准教授 (30631981)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 疫学 / 薬剤疫学 / リウマチ性疾患

Outline of Final Research Achievements

In this study, we conducted pharmacoepidemiological studies in rheumatic diseases using the large administrative claims data in Japan. First, we showed that the prescription of anchor drug (methotrexate, MTX) for patients with rheumatoid arthritis (RA) widespread nationwide although there were regional differences in the proportion of patients with RA who had visited specializing facilities for RA treatments. Second, it has been demonstrated that Janus kinase inhibitors had similar risk of cardiovascular diseases (CVD) with MTX, whereas, had significantly higher risk than tumor necrosis inhibitors. Third, in patients with systemic lupus erythematosus, frequency and risk factors of clinically important comorbidities such as serious infection, CVD, and osteonecrosis, and admission were revealed. In addition, medical costs and medications in patients with patients with vasculitis were also shown in this study.

Free Research Field

薬剤疫学

Academic Significance and Societal Importance of the Research Achievements

大規模データベースを使うことで、しばしば問題となる選択バイアスの影響が少ないことが特徴である。関節リウマチに対する治療の地域格差の有無を検討したのは本研究が初めてであり、我が国の関節リウマチ診療ガイドラインに有用なエビデンスの一部となった。特にヤヌスキナーゼ阻害薬の安全性については世界的にも注目されており、日本における上質なエビデンスが待たれていたため今回大規模集団でそのリスクが明らかになったことは意義深い。さらに、全身性エリテマトーデスや血管炎などの他のリウマチ性疾患においても薬剤疫学的なエビデンスを得ることができたため、これらの疾患における安全な薬物治療に繋がることが期待される。