Moderate to severe atopic dermatitis (
AD
) has a high disease burden and a significant effect on quality of life. Observational studies are necessary to determine the patient disease burden and long‐term disease control in the Japanese population.
ADDRESS
‐J is a non‐interventional, observational registry of adult Japanese patients with moderate to severe
AD
. Herein, we report baseline data from the
ADDRESS
‐J study describing disease characteristics and current treatment practices. At baseline, 300 adult
AD
patients with Investigator's Global Assessment (
IGA
) scores (range, 0–4) of 3 (moderate) or 4 (severe) whose treatments for
AD
were intensified, were assessed for clinical and patient‐reported outcomes and current
AD
treatments. The registry patients’ median age was 34.0 years; 60.7% were male and 71.7% had had
AD
for more than 20 years. At baseline, 220 study patients had an
IGA
score of 3 and 80 had an
IGA
score of 4. The median Eczema Area and Severity Index score was 21.7 (range, 0–72), the median body surface area involvement was 46.25%, and the median pruritus numerical rating scale score was 7.0 (range, 0–10); for each of these measures, higher scores represent greater severity. Most registry patients (86.7%) had recently used topical corticosteroids or topical calcineurin inhibitors as treatment for
AD
. This registry cohort represents a population of Japanese patients with moderate to severe
AD
and provides an important resource for characterizing the disease burden and evaluating the safety and effectiveness of various
AD
treatments.
Aims
To investigate the effects of sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors vs. dipeptidyl peptidase‐4 (DPP‐4) inhibitors on renal function preservation (RFP) using real‐world data of patients with type 2 diabetes in Japan, and to identify which subgroups of patients obtained greater RFP benefits with SGLT2 inhibitors vs. DPP‐4 inhibitors.
Methods
We retrospectively analysed claims data recorded in the Medical Data Vision database in Japan of patients with type 2 diabetes (aged ≥18 years) prescribed any SGLT2 inhibitor or any DPP‐4 inhibitor between May 2014 and September 2016 (identification period), in whom estimated glomerular filtration rate (eGFR) was measured at least twice (baseline, up to 6 months before the index date; follow‐up, 9 to 15 months after the index date) with continuous treatment until the follow‐up eGFR. The endpoint was the percentage of patients with RFP, defined as no change or an increase in eGFR from baseline to follow‐up. A proprietary supervised learning algorithm (Q‐Finder; Quinten, Paris, France) was used to identify the profiles of patients with an additional RFP benefit of SGLT2 inhibitors vs. DPP‐4 inhibitors.
Results
Data were available for 990 patients prescribed SGLT2 inhibitors and 4257 prescribed DPP‐4 inhibitors. The proportion of patients with RFP was significantly greater in the SGLT2 inhibitor group (odds ratio 1.27; P = 0.01). The Q‐Finder algorithm identified four clinically relevant subgroups showing superior RFP with SGLT2 inhibitors (P < 0.1): no hyperlipidaemia and eGFR ≥79 mL/min/1.73 m2; eGFR ≥79 mL/min/1.73 m2 and diabetes duration ≤1.2 years; eGFR ≥75 mL/min/1.73 m2 and use of antithrombotic agents; and haemoglobin ≤13.4 g/dL and LDL cholesterol ≥95.1 mg/dL. In each profile, glycaemic control was similar in the two groups.
Conclusion
SGLT2 inhibitors were associated with more favourable RFP vs. DPP‐4 inhibitors in patients with certain profiles in real‐world settings in Japan.
Little is known about the association between RP and pulmonary emphysema. Patients with severe emphysema had lower risk of RP than those with no underlying lung disease.
This study aims to examine the humanistic and economic burden of cardiovascular disease (CVD)-related comorbidities and hypoglycaemia among respondents with type 2 diabetes (T2D) in Japan. Methods: This study used the Japan National Health and Wellness Survey 2016 database. Respondents who self-reported a physician-diagnosed T2D were included. Respondents with or without the condition of interest (CVD-related comorbidities or hypoglycaemia) were compared via generalized linear models in terms of the outcome variables: (1) health-related quality of life (HRQoL), (2) work productivity and activity impairment, (3) healthcare resource utilization and (4) economic costs. Results: A total of 1478 survey respondents reported a diagnosis of T2D (mean age 63.6 ± 10.6 years, mean HbA1c 6.91 ± 1.1%). Of whom, 804 subjects (54.4%) had at least one CVD related comorbidities, and 369 subjects (29.3%) reported experiences of hypoglycaemia episodes. Patients with CVD-related comorbidities or hypoglycaemia episodes had worse HRQoL, more work and activity impairment, increased health care visits, and higher costs. Conclusions: CVD related comorbidities and hypoglycaemia remains a significant humanistic and economic burden in patients with T2D. The findings suggested that appropriate T2D management with proper medication choice are important to control CVD related comorbidities and hypoglycaemia among T2D patients to alleviate the burden.
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