日本免疫功能低下/慢性病患者群体中带状疱疹的负担：一项基于2005 - 2014年队列研究索赔数据库的结果
Burden of Herpes Zoster in the Japanese Population with Immunocompromised/Chronic Disease Conditions: Results from a Cohort Study Claims Database from 2005-2014.
作者信息
Imafuku Shinichi, Matsuki Taizo, Mizukami Akiko, Goto Yasushi, de Souza Sabrina, Jégou Céline, Bianco Veronique, Rosillon Dominique, Ito Chie, Curran Desmond, Holl Katsiaryna
机构信息
Department of Dermatology, School of Medicine, Fukuoka University, Fukuoka, Japan.
Healthoutcomes Department, GSK, Tokyo, Japan.
出版信息
Dermatol Ther (Heidelb). 2019 Mar;9(1):117-133. doi: 10.1007/s13555-018-0268-8. Epub 2018 Nov 19.
INTRODUCTION
The aim of this study is to describe the disease burden and costs of herpes zoster (HZ) in the general adult Japanese population or patients with immunocompromised (IC) conditions or chronic disorders.
METHODS
A retrospective cohort study of individuals aged 18-74 years was conducted using January 2005 to December 2014 records from the Japan Medical Data Center claims database. Twenty-eight IC conditions and chronic disorders were defined by diagnosis codes and/or procedures/treatments. HZ and its related complications were identified. Incidence rates (IR), frequency of HZ-related complications, healthcare resource utilization (HRU), and direct medical costs were estimated. HRU and costs were estimated on a subcohort of HZ cases occurring April 2012-January 2014.
RESULTS
The overall IR of HZ in the total cohort of 2,778,476 adults was 4.92/1000 person-years (PY) [95% confidence interval (CI): 4.86-4.98] and increased with age. The IR in the IC cohort (51,818 subjects) was 8.87/1000 PY (95% CI: 8.29-9.48), ranging from 5.55/1000 PY (95% CI: 4.26-7.09) in psoriasis to 151.68/1000 PY (95% CI: 111.45-201.71) in hematopoietic stem cell transplant recipients; most IRs were in the range 6-10/1000 PY. The IRs in individuals with chronic disorders were also relatively high, in the range 5.40-12.90/1000 PY. The frequency of postherpetic neuralgia was 4.01% (95% CI: 3.72-4.33) in the total cohort and 11.73% (95% CI: 9.01-14.93) in the IC cohort. The mean [standard deviation (SD)] number of outpatient visits was 3.4 (4.9) and 5.0 (5.7), respectively, and the proportion of HZ patients hospitalized was 2.20% and 6.70%, respectively. The mean (SD) direct medical cost per HZ episode was ¥34,664 (¥54,433) and ¥55,201 (¥92,642) in the total and IC cohort, respectively.
CONCLUSIONS
The elevated burden of HZ in Japanese individuals harboring IC conditions and chronic disorders documented in our study underlines the need for prevention of HZ in people with these conditions.
FUNDING
GlaxoSmithKline Biologicals SA.
引言
本研究旨在描述日本普通成年人群、免疫功能低下（IC）患者或患有慢性疾病患者中带状疱疹（HZ）的疾病负担和成本。
方法
利用日本医疗数据中心索赔数据库2005年1月至2014年12月的记录，对18 - 74岁个体进行回顾性队列研究。通过诊断代码和/或程序/治疗定义了28种IC疾病和慢性疾病。确定了HZ及其相关并发症。估计了发病率（IR）、HZ相关并发症的频率、医疗资源利用率（HRU）和直接医疗成本。HRU和成本是根据2012年4月至2014年1月发生的HZ病例亚组进行估计的。
结果
在2,778,476名成年人的总队列中，HZ的总体IR为4.92/1000人年（PY）[95%置信区间（CI）：4.86 - 4.98]，且随年龄增加。IC队列（51,818名受试者）中的IR为8.87/1000 PY（95% CI：8.29 - 9.48），范围从银屑病患者的5.55/1000 PY（95% CI：4.26 - 7.09）到造血干细胞移植受者的151.68/1000 PY（95% CI：111.45 - 201.71）；大多数IR在6 - 10/1000 PY范围内。患有慢性疾病个体的IR也相对较高，在5.40 - 12.90/1000 PY范围内。带状疱疹后神经痛的频率在总队列中为4.01%（95% CI：3.72 - 4.33），在IC队列中为11.73%（95% CI：9.01 - 14.93）。门诊就诊的平均[标准差（SD）]次数分别为3.4（4.9）和5.0（5.7），HZ患者住院的比例分别为2.20%和6.70%。总队列和IC队列中每例HZ发作的平均（SD）直接医疗成本分别为34,664日元（54,433日元）和55,201日元（92,642日元）。
结论
我们的研究记录了日本患有IC疾病和慢性疾病个体中HZ负担的增加，强调了对这些患者预防HZ的必要性。
资助
葛兰素史克生物制品公司。
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