Background: We investigated the impact of early-(E-CMV) and late onset (L-CMV)

IntroductionCrohn’s disease (CD) is a chronic and progressive disease in which the long-term management is important. This study sought to assess treatment persistence and dose escalation in the maintenance phase with adalimumab (ADA) or infliximab (IFX) in a Japanese real-world setting.MethodsA retrospective analysis was conducted using the Japan Medical Data Center database. CD patients with either ADA or IFX prescriptions between January 2012 and February 2015 were included. Outcomes of interest were (1) failure in the induction phase (defined as switch or discontinuation) and (2) persistence in the maintenance phase (defined as the absence of switch or discontinuation over 12 months since maintenance initiation).ResultsOverall, 133 patients (53 ADA; 80 IFX) were included. Of them, treatment failed in 26 patients (19.6%) in the induction phase. During the induction phase, there was a trend towards fewer treatment failures with ADA than IFX (88.7% vs. 75.0%; p = 0.051). Of those who completed induction, 64 patients (33 ADA; 31 IFX) had at least 12 months of valid insurance enrolment after the initiation of maintenance and 13 (5 ADA; 8 IFX) had either switch or discontinuation within 12 months after the initiation of maintenance. Probabilities of switch or discontinuation over 12 months after the maintenance date were 15.2% and 20.9% for ADA and IFX groups, respectively (p-log rank = 0.7764).ConclusionJapanese patients have a high primary response to anti-tumor necrosis factor therapy in the real-world setting, in line with the results of clinical trials. This initial therapeutic advantage can be lost during the maintenance phase, leading to dose escalation, treatment switch, or discontinuation. This study suggests that those events occurred in comparable proportions of patients treated with either ADA or IFX. However, these findings should be considered with caution given the retrospective nature and small size of the study.FundingAbbvie GK, Tokyo, Japan.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-016-0406-6) contains supplementary material, which is available to authorized users.

ObjectivesLittle is known about the economic burden of influenza‐related hospitalizations in Japan. This study sought to identify the factors that contribute to the total healthcare costs (THCs) associated with hospitalizations due to influenza in the Japanese population.Study designA retrospective cross‐sectional database analysis study.MethodsA structural equation modelling approach was used to analyse a nationwide Japanese hospital claims data. This study included inpatients with at least 1 confirmed diagnosis of influenza and with a hospital stay of at least 2 days, who were admitted between April 2014 and March 2015.ResultsA total of 5261 Japanese inpatients with a diagnosis of influenza were included in the final analysis. The elderly (≥65 years) and the young (≤15 years) comprised more than 85% of patients. The average length of stay (LOS) was 12.5 days, and the mean THC was 5402 US dollars (US$) per hospitalization. One additional hospital day increased the THC by 314 US$. Intensive care unit hospitalizations were linked to higher costs (+4957 US$) compared to regular hospitalizations. The biggest procedure‐related cost drivers, which were also impacted by LOS, were blood transfusions (+6477 US$), tube feedings (+3501 US$) and dialysis (+2992 US$).ConclusionsIn Japan, the economic burden due to influenza‐related hospitalizations for both children and the elderly is considerable and is further impacted by associated comorbidities, diagnostic tests and procedures that prolong the LOS.

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1. In semi-natural grasslands, nest trampling by cattle can have a strong effect on hatching success but the relationship linking cattle density, incubation time and nest survival has for now only been hypothesized. 2. Based on an experiment with artificial nests, the objective of this study was to test the theoretical model generally used to estimate nest survival. In spring 2009, we conducted a one-month experiment on permanent grasslands of the French western marshlands grazed at three different stocking rates (1 LU.ha-1, 2 LU.ha-1 and 4 LU.ha-1). 3. The results confirmed that trampling depended on stocking rates. 4. Trampling had a major effect on nest survival (32-85% of nests destroyed). 5. The theoretical model classically used by managers and modellers proved to be a good approximation of the dynamics of nest trampling. 6. Synthesis and applications: We conclude that nest trampling has a major impact on nest survival in pastures and that the use of such a model could help managers to define acceptable levels of cattle densities. INTRODUCTION ABSTRACT KEYWORDS