カツマタ　ヤスヒロ   勝又　康弘    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Patterns of Medication Use in Systemic Lupus Erythematosus: A Multicenter Cohort Study.
掲載誌名	正式名：Arthritis care & research 略　 称：Arthritis Care Res (Hoboken) ISSNコード：21514658/2151464X
巻・号・頁	74(12),pp.2033-2041
著者・共著者	Kandane-Rathnayake Rangi, Louthrenoo Worawit, Luo Shue-Fen, Wu Yeong-Jian J, Chen Yi-Hsing, Golder Vera, Lateef Aisha, Cho Jiacai, Navarra Sandra V, Zamora Leonid, Hamijoyo Laniyati, Sockalingam Sargunan, An Yuan, Li Zhanguo, Montes Ricardo, Oon Shereen, Katsumata Yasuhiro, Harigai Masayoshi, Hao Yanjie, Zhang Zhuoli, Chan Madelynn, Kikuchi Jun, Takeuchi Tsutomu, Goldblatt Fiona, O'Neill Sean, Bae Sang-Cheol, Lau Chak S, Hoi Alberta, Karyekar Chetan S, Nikpour Mandana, Morand Eric F,
発行年月	2022/12
概要	OBJECTIVE:Evidence for the utility of medications in settings lacking randomized trial data can come from studies of treatment persistence. The present study was undertaken to examine patterns of medication use in systemic lupus erythematosus (SLE) using data from a large multicenter longitudinal cohort.METHODS:Prospectively collected data from the Asia Pacific Lupus Collaboration cohort including disease activity (SLE Disease Activity Index 2000 [SLEDAI-2K]) and medication details, captured at every visit from 2013-2018, were used. Medications were categorized as glucocorticoids (GCs), antimalarials (AM), and immunosuppressants (IS). Cox regression analyses were performed to determine the time-to-discontinuation of medications, stratified by SLE disease activity.RESULTS:Data from 19,804 visits of 2,860 patients were analyzed. Eight medication categories were observed: no treatment; GC, AM, or IS only; GC plus AM; GC plus IS; AM plus IS; and GC plus AM plus IS (triple therapy). Triple therapy was the most frequent pattern (31.4% of visits); single agents were used in 21% of visits, and biologics in only 3%. Time-to-discontinuation analysis indicated that medication persistence varied widely, with the highest treatment persistence for AM and lowest for IS. Patients with a time-adjusted mean SLEDAI-2K score of ≥10 had lower discontinuation of GCs and higher discontinuation of IS.CONCLUSION:Most patients received combination treatment. GC persistence was high, while IS persistence was low. Patients with high disease activity received more medication combinations but had reduced IS persistence, consistent with limited utility. These data confirm unmet need for improved SLE treatments.
DOI	10.1002/acr.24740
PMID	34197023