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( 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.
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