PE-167: High Prevalence of Comorbidities and Contraindicated Medications in HCV Patients in Japan

( Hiroshi Yotsuyanagi ),( Eliza Kruger ),( Seng Tan ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: To determine the prevalence of comorbidities and drug-drug interactions (DDIs) in CHC patients in Japan. Methods: Patients were identified using the ICD10 code for CHC in the Japanese Medical Data Center (MDC) database (04/2008-08/2014). Prescriptions were categorized as either red (contraindicated) or amber (additional monitoring/dose reduction required) for DDI potential with at least one currently licensed direct-acting antiviral (DAA). Results: 92,294 patients were identified, average age was 68 and 52% male. 82% of patients had one or more comorbidity; the number with 6+ comorbidities increased with age from 2% of patients aged 18-34 to 17% for patients 75+. The most common were hypertension (44%), chronic gastritis (33%) and gastro-oesophageal reflux disease (32%). 74% were treated with amber DDIs and 26% were on red. Polypharmacy increased with age, from 43% for 18-34 to 82% for 75+ (amber) and from 13% to 29% for 18-34 year olds and 75+ respectively (red). Only 8.2% of patients were treated for CHC. Of these, 81% had a potential DDI, increasing from 61% for 18-34 years to 90% for 75+. Conclusions: We observed significant co-morbidity and co-prescribing with DDI potential in CHC patients in Japan. Few patients received SVR treatment, indicating a large unmet need in Japan. With the treatment shift from interferon to DAA’s, more patients may receive treatment. Hence, the high proportion of co-medications contraindicated to all DAA’s vs. only some suggests careful selection of the DAA regimen is required. Treating patients at a younger age would also reduce the risk of DDI.

Increasing Age and Comorbidities in 13,639 Adult Patients with Chronic Hepatitis B (CHB) from 2011 to 2016 in Japan

( Hiroshi Yotsuyanagi ),( Hiroshi Yatsuhashi ),( Masayuki Kurosaki ),( Richard Zur ),( Steve Sherman ),( Mindie H. Nguyen ),( Sooji Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: CHB affects approximately 1% of the general population in Japan with higher prevalence in older people. This study aims to characterize the evolving CHB patient demographics and comorbidity burden in Japan as well as their changes over 2011- 2016. Methods: We used the Medical Data Vision (MDV) claims database to identify patients =18 years with =1 ICD-10 codes for CHB (B18.1), having =1 HBsAg test and =1 HBeAg test, viral load test, or HB core antibody test. Patients were required to have continuous enrollment for 6 months prior and post index date (first date of CHB diagnosis) during 1/1/2011-12/31/2016. Patient demographic and comorbidity data was reported from 2011 to 2016. Results: A total of 13,639 patients met inclusion and exclusion criteria. Males made up 58% of patients in 2011 and decreased to 54% in 2016 (P<0.0001). The average age of patients was 60.7±13.1 years in 2011 and increased to 63.9±13.2 years in 2016 (P<0.0001). The proportion of the population over 65 increased from 42% in 2011 to 57% in 2016 (P<0.0001). The Charlson comorbidity index, an overall measure of patient comorbidity (covering 17 conditions), increased from 2.7 to 3.7 (P<0.0001) from 2011 to 2016. In 2016, 14% of CHB patients in Japan had diabetes (DM), 16% with nonalcoholic fatty liver disease, 5% with chronic kidney disease (CKD), and 9% with fragility (non-traumatic) bone fractures; all of which have increased significantly from 2011 (all P<0.05) [Figure 1]. Similarly there was a high prevalence of comorbidities in 2016 such as hypertension (38%), renal impairment (20%), hyperlipidemia (19%), liver impairment (15%), and osteoporosis (9%), although these did not show a significant increase over time. Conclusions: Between 2011 and 2016, the Japanese CHB population has aged (~80% =55) and are having more comorbidities, which may affect CHB management and should be considered in their treatment and monitoring.

Preliminary Analysis of Interconnect Full Open Faults using TEG chips

Toshiyuki Tsutsumi,Yasuyuki Kariya,Masaki Hashizume,Hiroyuki Yotsuyanagi,Koji Yamazaki,Yoshinobu Higami,Hiroshi Takahashi,Yuzo Takamatsu 대한전자공학회 2009 ITC-CSCC :International Technical Conference on Ci Vol.2009 No.7

As LSIs are scale-down, there is an increasing need to take measures against open faults. However, no practical model for open faults exists at present. Therefore, we fabricated Test Element Group (TEG) chips that intentionally incorporated full (complete) open defects and electrically measured the output signals relevant to its defective lines in order to create a new model for open fault behavior. This study reveals the effect boundary of adjacent signal lines on the line containing the full open defect for the first time using the TEG chips.

Repair Circuit of TSVs in a 3D Stacked Memory IC

Yuki Ikiri,Masaki Hashizume,Hiroyuki Yotsuyanagi,Hiroshi Yokoyama,Tetsuo Tada,Shyue-Kung Lu 대한전자공학회 2015 ITC-CSCC :International Technical Conference on Ci Vol.2015 No.6

A repair circuit for TSVs (Through Silicon Vias) in a 3D stacked memory IC is proposed in this paper. The circuit is made of a switch circuit and a switch control circuit so as for a defective TSV to be connected to a defect-free TSV. The circuit is evaluated by Spice simulation. The results show us that a TSV is connected to a defect-free one with small area overhead and additional delay.

Fault Analysis of Interconnect Opens in 90nm CMOS ICs with Device Simulator

Masaki Hashizume,Yuichi Yamada,Hiroyuki Yotsuyanagi,Toshiyuki Tsutsumi,Koji Yamazaki,Yoshinobu Higami,Hiroshi Takahashi,Yuzo Takamatsu 대한전자공학회 2008 ITC-CSCC :International Technical Conference on Ci Vol.2008 No.7

In this paper, faulty effects of interconnect opens in logic ICs fabricated with a 90㎚ CMOS process are analyzed by device simulation. In the analysis, it is examined whether a logical error can be caused at an opened input signal line by logic signals of the neighboring signal lines. The simulation results suggest us that a logical error may occur at an interconnect surrounding by 8 interconnects if the interconnects are longer than 5㎛ and the width of an open defect is greater than 2.0㎚.

Patient Characteristics and Medication Burden of Chronic Hepatitis C Patients in Japan from a Nationwide Real World Hospital Claims Database

( Takeya Tsutsumi ),( Craig Brooks-rooney ),( Bryony Langford ),( Hiroshi Yotsuyanagi ),( Sooji Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Japanese patients with CHC are elderly and may possess more comorbidities and higher pill burden. This study describes the pill burden and comorbidities in Japanese CHC patients in the Medical Data Vision (MDV) claims database. Methods: This was a retrospective cohort study of ≥18 years old patients with CHC (ICD-10: B18.2) from 2008-2016. Age and gender were derived from the database for the most recent CHC visit. Comorbidity prevalence was assessed using ICD-10 codes. Patients who had received all oral direct acting antiviral (DAA) therapy were identified through receipt code for a prescription for a DAA. The average number of tablets (‘pill burden’) taken by DAA-treated patients was calculated for the 90 days prior/post first prescription date of a DAA. Results: The study population included 173,796 patients (mean ±SD age 69±14, 51.7% male), with a large proportion ≥75 years old (40.7%). Prevalent comorbidities included hypertension (41.4%) and type 2 diabetes (18.3%). Patients within the sample experienced a mean of 3.54±2.98 comorbidities, with elderly HCV patients experiencing more comorbidities than younger HCV patients (age group 18-34 vs. 75+; 1.17±1.64 vs. 4.33±3.09; P< 0.001). The 10 most prevalent comorbidities are displayed in Table 1, with most increasing with age. 19,683 patients satisfied criteria for pill burden analysis. Pre- and post- DAA treatment initiation mean pill burden was 4.23±11.4 pills/ day and 6.72±12.17 pills/day, respectively. Pill burden was higher among older patients, with those aged over 75 experiencing mean pill counts of 5.2±13.27 and 7.12±12.05 pre- and post-index, respectively. A greater proportion of elderly patients had a pill burden of >10 after initiating DAA treatment, compared to those in younger age groups (age group 18-34 vs. 75+; 4.2% vs. 21.6%; P<0.001). Conclusions: The majority of Japanese CHC patients are elderly with several comorbidities and high pill burden pre-DAA treatment, which may be an important consideration for CHC regimen selection.