- 著者
- Jia GUAN Shiro TANAKA Shuhei YAMADA Izumi SATO Koji KAWAKAMI
- 出版者
- Japanese Society for Pharmacoepidemiology
- 雑誌
- 薬剤疫学 (ISSN:13420445)
- 巻号頁・発行日
- pp.25.e2, (Released:2020-07-15)
- 参考文献数
- 32
- 被引用文献数
- 1 1
Objective: To describe the treatment patterns and time to next treatment (TTNT) in newly diagnosed multiple myeloma patients (MM) using a large-scale claims database in Japan.Design: Cohort studyMethods: The patients with newly diagnosed MM from 2008 to 2015 were classified into two groups: age <65 years, and age ≥65 years. Specific regimens and general regimens were identified with a complex algorithm considering interval of no therapy, additional and discontinued agents. Correspondingly, TTNT between the first- and second-line were measured among non-transplant patients with Kaplan-Meier method.Results: A total of 425 patients were eligible to participate in the analysis. The most common regimen for the treatment of MM was bortezomib-based regimens (52.9% in the first-line, 28.2% in later lines), followed by melphalan-prednisolone (27.1% in the first-line, 12.9% in later lines) and lenalidomide-based regimens (4.7% in the first-line, 26.1% in later lines). TTNT between the first- and second-line was 11.4 months and was seen to vary greatly with each regimen. A statistically longer TTNT was observed in subgroups of patients aged 65 years or over compared with patients aged younger than 65 years, but no statistical difference was found between conventional therapy and novel therapy.Conclusion: Based on the data from the study, patients with MM were commonly treated with novel agent-based regimens, especially bortezomib-based regimens. Between the first- and second-line therapies a relatively short TTNT was observed, indicating that therapies in clinical practice poorly complied with treatment guidelines.
- 著者
- Tomomi KIMURA Toshifumi SUGITANI Takuya NISHIMURA Masanori ITO
- 出版者
- Japanese Society for Pharmacoepidemiology
- 雑誌
- 薬剤疫学 (ISSN:13420445)
- 巻号頁・発行日
- vol.24, no.2, pp.53-64, 2019-08-27 (Released:2019-10-07)
- 参考文献数
- 25
- 被引用文献数
- 15 14
Objective: The Charlson and Elixhauser comorbidity indices (CCI and ECI, respectively) are widely used to study comorbid conditions but these indices have not been validated in Japanese datasets. In this study, our objective was to validate and recalibrate CCI and ECI in a Japanese insurance claims database.Methods: All hospitalizations for patients aged≥18 years discharged between January 2011 and December 2016 were randomly allocated to derivation and validation cohorts. Predictability for hospital death and re-admission was evaluated using C statistics from multivariable logistic regression models including age, sex, and individual CCI/ECI conditions at admission month or the derived score in the derivation cohort. After stepwise variable selection, weighted risk scores for each condition were re-assigned using odds ratios (CCI) or beta coefficients (ECI). The modified models were evaluated in the validation cohort.Results: The original CCI/ECI had good discriminatory power for hospital death: C statistics (95% confidence interval) for individual comorbidities and score models were 0.845 (0.835-0.855) and 0.823 (0.813-0.834) for CCI, and 0.839 (0.828-0.850) and 0.801 (0.790-0.812) for ECI, respectively. Modified CCI and ECI had reduced numbers of comorbidities (17 to 10 and 30 to 21, respectively) but maintained comparable discriminatory abilities: C statistics for modified individual comorbidities and score models were 0.843 (0.833-0.854) and 0.838 (0.827-0.848) for CCI, and 0.840 (0.828-0.852) and 0.839 (0.827-0.851) for ECI, respectively.Conclusions: The original and modified models showed comparable discriminatory abilities and both can be used in future studies using insurance claims databases.