日本白癜风的临床模式:使用JMDC索赔数据库的描述性研究。

Atsushi Tanemura, Yue Ma, Masayo Sakaki-Yumoto, Shintaro Hiro, Tomohiro Hirose, Tamio Suzuki
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引用次数: 0

摘要

白癜风是一种慢性自身免疫性疾病,严重影响患者的生活质量。日本白癜风的真实数据有限。这项描述性横断面研究使用索赔数据库来评估日本白癜风患者的白癜风患病率、患者人口统计、治疗和合并症。2010年1月至2022年12月在JMDC数据库中被诊断为白癜风的患者被纳入研究。分析白癜风年度患病率、合并症、治疗和医疗机构就诊情况。在13年的分析期间,数据库中的16 947 087例患者中,共有26 358例(0.16%,95%可信区间0.15-0.16)被诊断为白癜风。日本按性别和年龄划分的白癜风标准化患病率在2010年(0.051%)和2022年(0.056%)之间基本保持一致。特应性皮炎是最常见的合并症。共病性特应性皮炎患病率在2010年(21.8%)至2022年(34.0%)期间有所增加,其中5-9岁儿童患病率最高。2022年的其他常见合并症包括高血压(10.4%)、血脂异常(8.0%)、焦虑症(7.4%)和牛皮癣(7.0%)。在整个分析期间,外用皮质类固醇是最常用的治疗方法。2010年至2022年间,局部皮质类固醇的使用从75.1%下降到66.9%,窄带紫外线B手术的使用从19.2%上升到28.1%。平均护理时间为12.9个月(标准差为20.5个月),门诊总次数中位数为3.0次(四分位数间距为1.0-12.0)。主要的限制包括JMDC数据库中的年龄和职业偏差,以及由于标签外治疗编码而导致的合并症的潜在错误分类。尽管在使用索赔数据库方面存在局限性,但本研究表明,白癜风在日本的患病率是一致的,合并症负担高,治疗模式也在不断发展。研究结果可以指导临床实践和治疗指南,以改善日本白癜风患者的管理。
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Clinical patterns of vitiligo in Japan: A descriptive study using the JMDC claims database.

Vitiligo is a chronic autoimmune disorder that profoundly impacts patients' quality of life. Real-world data on vitiligo in Japan are limited. This descriptive, cross-sectional study used a claims database to evaluate vitiligo prevalence, patient demographics, treatments, and comorbidities in Japanese patients with vitiligo. Patients with claims for a vitiligo diagnosis in the JMDC database from January 2010 to December 2022 were included. Annual vitiligo prevalence, comorbidities, treatments, and medical facility visits were analyzed. Of 16 947 087 patients in the database during the 13-year analysis period, a total of 26 358 patients (0.16%, 95% confidence interval 0.15-0.16) had a diagnosis of vitiligo. The standardized prevalence of vitiligo by sex and age in Japan remained generally consistent between 2010 (0.051%) and 2022 (0.056%). Atopic dermatitis was the most prevalent comorbidity. Comorbid atopic dermatitis prevalence increased between 2010 (21.8%) and 2022 (34.0%), and was highest among children aged 5-9 years. Other common comorbidities in 2022 included hypertension (10.4%), dyslipidemia (8.0%), anxiety disorder (7.4%), and psoriasis (7.0%). Topical corticosteroids were the most commonly used treatment throughout the period analyzed. Between 2010 and 2022, topical corticosteroid use decreased from 75.1% to 66.9%, and the use of narrowband ultraviolet B procedures increased from 19.2% to 28.1%. Mean duration of care was 12.9 months (standard deviation 20.5 months) and the median total number of outpatient medical facility visits was 3.0 (interquartile range 1.0-12.0). Key limitations include age and occupational biases in the JMDC database and potential misclassification of comorbidities due to off-label treatment coding. Despite limitations in using a claims database, this study demonstrates consistent vitiligo prevalence in Japan, a high comorbidity burden, and evolving treatment patterns. Findings may guide clinical practice and treatment guidelines to improve management of vitiligo in Japanese patients.

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