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Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database

Pulmonary arterial hypertension (PAH) is a fatal disease that often occurs at an early age. In recent years, aggressive treatment with multiple drugs from the early‐stage diagnosis is expected to improve the prognosis. Indeed, a high rate of initial combination therapy and excellent treatment outcom...

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Autores principales: Omura, Junichi, Kitahara, Kazuki, Takano, Masashi, Idehara, Koki, Kim, Seok‐Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462924/
https://www.ncbi.nlm.nih.gov/pubmed/37649808
http://dx.doi.org/10.1002/pul2.12275
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author Omura, Junichi
Kitahara, Kazuki
Takano, Masashi
Idehara, Koki
Kim, Seok‐Won
author_facet Omura, Junichi
Kitahara, Kazuki
Takano, Masashi
Idehara, Koki
Kim, Seok‐Won
author_sort Omura, Junichi
collection PubMed
description Pulmonary arterial hypertension (PAH) is a fatal disease that often occurs at an early age. In recent years, aggressive treatment with multiple drugs from the early‐stage diagnosis is expected to improve the prognosis. Indeed, a high rate of initial combination therapy and excellent treatment outcomes have been reported from specialized centers for PAH in Japan. However, information on PAH epidemiology, including non‐PAH specialized centers in Japan, is unclear. To address the above, we conducted a retrospective observational cohort study from April 2008 to September 2020 using real‐world evidence from a large‐scale administrative database (Medical Data Vision) to examine baseline characteristics, comorbidities, and treatment profiles of Japanese patients with PAH. Five hundred and eighteen patients with PAH (treatment‐naive PAH, age 67.2 ± 15.9) were identified through our comprehensive approach which combined PAH disease codes, medications, and diagnostic procedures. Moreover, we showed that a larger proportion of patients received monotherapy in their initial treatment (66%) compared to those receiving combination therapy (34%). During the 1‐year follow‐up after PAH diagnosis, 13% of patients increased their PAH medications while other patients either decreased their PAH medications (6%) or discontinued PAH treatment (27%). The 3‐ and 5‐year event‐free survival rates of all‐cause death were 72% and 64%, respectively. This is the first large‐scale administrative database study that provides insights into real‐world PAH management in Japan. This study highlighted a different PAH clinical landscape which included a larger portion of the elderly population, higher initial monotherapy treatment, and lower survival rates than previous studies.
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spelling pubmed-104629242023-08-30 Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database Omura, Junichi Kitahara, Kazuki Takano, Masashi Idehara, Koki Kim, Seok‐Won Pulm Circ Research Articles Pulmonary arterial hypertension (PAH) is a fatal disease that often occurs at an early age. In recent years, aggressive treatment with multiple drugs from the early‐stage diagnosis is expected to improve the prognosis. Indeed, a high rate of initial combination therapy and excellent treatment outcomes have been reported from specialized centers for PAH in Japan. However, information on PAH epidemiology, including non‐PAH specialized centers in Japan, is unclear. To address the above, we conducted a retrospective observational cohort study from April 2008 to September 2020 using real‐world evidence from a large‐scale administrative database (Medical Data Vision) to examine baseline characteristics, comorbidities, and treatment profiles of Japanese patients with PAH. Five hundred and eighteen patients with PAH (treatment‐naive PAH, age 67.2 ± 15.9) were identified through our comprehensive approach which combined PAH disease codes, medications, and diagnostic procedures. Moreover, we showed that a larger proportion of patients received monotherapy in their initial treatment (66%) compared to those receiving combination therapy (34%). During the 1‐year follow‐up after PAH diagnosis, 13% of patients increased their PAH medications while other patients either decreased their PAH medications (6%) or discontinued PAH treatment (27%). The 3‐ and 5‐year event‐free survival rates of all‐cause death were 72% and 64%, respectively. This is the first large‐scale administrative database study that provides insights into real‐world PAH management in Japan. This study highlighted a different PAH clinical landscape which included a larger portion of the elderly population, higher initial monotherapy treatment, and lower survival rates than previous studies. John Wiley and Sons Inc. 2023-08-29 /pmc/articles/PMC10462924/ /pubmed/37649808 http://dx.doi.org/10.1002/pul2.12275 Text en © 2023 Janssen Pharmaceuticals, K.K. and The Authors. Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Research Articles
Omura, Junichi
Kitahara, Kazuki
Takano, Masashi
Idehara, Koki
Kim, Seok‐Won
Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database
title Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database
title_full Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database
title_fullStr Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database
title_full_unstemmed Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database
title_short Real‐world clinical practice of pulmonary arterial hypertension in Japan: Insights from a large administrative database
title_sort real‐world clinical practice of pulmonary arterial hypertension in japan: insights from a large administrative database
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462924/
https://www.ncbi.nlm.nih.gov/pubmed/37649808
http://dx.doi.org/10.1002/pul2.12275
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