Public support for patients with intractable diseases in Japan: impact on clinical indicators from nationwide registries in patients with autosomal dominant polycystic kidney disease.

Humans Tolvaptan / therapeutic use Polycystic Kidney, Autosomal Dominant / diagnosis Antidiuretic Hormone Receptor Antagonists / therapeutic use Japan / epidemiology Antihypertensive Agents / therapeutic use Registries
Antihypertensive Autosomal dominant polycystic kidney disease Clinical indicator Intractable disease Quality indicator Tolvaptan

Journal

Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 28 04 2023
accepted: 11 06 2023
medline: 18 9 2023
pubmed: 27 6 2023
entrez: 27 6 2023
Statut: ppublish

Résumé

Clinical practice guidelines recommend antihypertensive and tolvaptan therapies for patients with autosomal dominant polycystic kidney disease (ADPKD) in Japan. However, tolvaptan therapy may pose an economic burden. The Japanese Ministry of Health, Labour and Welfare supports patients with intractable diseases. This study aimed to confirm the impact of the intractable disease system in Japan on the clinical treatment of ADPKD. We analyzed the data of 3768 patients with ADPKD having a medical subsidy certificate from the Japanese Ministry of Health, Labour and Welfare in 2015-2016. The following quality indicators were use: the adherence rate to the 2014 clinical practice guideline for polycystic kidney disease (prescription rates of antihypertensive agents and tolvaptan in this cohort) and the number of Japanese patients with ADPKD nationwide started on renal replacement therapy in 2014 and 2020. Compared with new applications from 2015 to 2016, the prescription rates of antihypertensives and tolvaptan for the indicated patients at the 2017 renewal application increased by 2.0% (odds ratio = 1.41, p = 0.008) and 47.4% (odds ratio = 10.1, p > 0.001), respectively. These quality indicators improved with antihypertensive treatment, especially in patients with chronic kidney disease stages 1-2 (odds ratio = 1.79, p = 0.013) and in those aged < 50 years (odds ratio = 1.70, p = 0.003). The number of patients with ADPKD who were started on renal replacement therapy in Japan decreased from 999 in 2014 to 884 in 2020 in the nationwide database (odds ratio = 0.83, p < 0.001). The Japanese public intractable disease support system contributes to improvement of ADPKD treatment.

Sections du résumé

BACKGROUND BACKGROUND
Clinical practice guidelines recommend antihypertensive and tolvaptan therapies for patients with autosomal dominant polycystic kidney disease (ADPKD) in Japan. However, tolvaptan therapy may pose an economic burden. The Japanese Ministry of Health, Labour and Welfare supports patients with intractable diseases. This study aimed to confirm the impact of the intractable disease system in Japan on the clinical treatment of ADPKD.
METHODS METHODS
We analyzed the data of 3768 patients with ADPKD having a medical subsidy certificate from the Japanese Ministry of Health, Labour and Welfare in 2015-2016. The following quality indicators were use: the adherence rate to the 2014 clinical practice guideline for polycystic kidney disease (prescription rates of antihypertensive agents and tolvaptan in this cohort) and the number of Japanese patients with ADPKD nationwide started on renal replacement therapy in 2014 and 2020.
RESULTS RESULTS
Compared with new applications from 2015 to 2016, the prescription rates of antihypertensives and tolvaptan for the indicated patients at the 2017 renewal application increased by 2.0% (odds ratio = 1.41, p = 0.008) and 47.4% (odds ratio = 10.1, p > 0.001), respectively. These quality indicators improved with antihypertensive treatment, especially in patients with chronic kidney disease stages 1-2 (odds ratio = 1.79, p = 0.013) and in those aged < 50 years (odds ratio = 1.70, p = 0.003). The number of patients with ADPKD who were started on renal replacement therapy in Japan decreased from 999 in 2014 to 884 in 2020 in the nationwide database (odds ratio = 0.83, p < 0.001).
CONCLUSIONS CONCLUSIONS
The Japanese public intractable disease support system contributes to improvement of ADPKD treatment.

Identifiants

DOI: 10.1007/s10157-023-02372-8 PMID: 37368094
pubmed: 37368094
doi: 10.1007/s10157-023-02372-8
pii: 10.1007/s10157-023-02372-8
doi:

Substances chimiques

Tolvaptan 21G72T1950
Antidiuretic Hormone Receptor Antagonists 0
Antihypertensive Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

809-818

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.

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Auteurs

Hiroshi Kataoka (H)

Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

Yosuke Shimada (Y)

Intelligent Systems Laboratory, SECOM CO., LTD. Mitaka, Tokyo, Japan.
Department of Medical Eleactronic Intelligence Management, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Tomonori Kimura (T)

Reverse Translational Research Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Osaka, Japan.

Saori Nishio (S)

Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Shinya Nakatani (S)

Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan.

Toshio Mochizuki (T)

Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
PKD Nephrology Clinic, Tokyo, Japan.

Ken Tsuchiya (K)

Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan.

Junichi Hoshino (J)

Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

Fumihiko Hattanda (F)

Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Haruna Kawano (H)

Department of Urology, Department of Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan.

Kazushige Hanaoka (K)

Department of General Internal Medicine, The Jikei University, Tokyo, Japan.

Sumi Hidaka (S)

Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa, Japan.

Daisuke Ichikawa (D)

Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kanagawa, Japan.

Eiji Ishikawa (E)

Department of Internal Medicine, Saiseikai Matsusaka General Hospital, Mie, Japan.

Kiyotaka Uchiyama (K)

Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Hiroki Hayashi (H)

Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.

Shiho Makabe (S)

Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

Shun Manabe (S)

Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

Michihiro Mitobe (M)

Department of Nephrology, Takeda General Hospital, Fukushima, Japan.

Akinari Sekine (A)

Department of Nephrology, Toranomon Hospital, Tokyo, Japan.

Tatsuya Suwabe (T)

Department of Nephrology, Toranomon Hospital, Tokyo, Japan.

Hirayasu Kai (H)

Pathophysiology of Renal Diseases, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Mahiro Kurashige (M)

Nephrology and Hypertension, Department of Internal Medicine, The Jikei University, Tokyo, Japan.

Koichi Seta (K)

Department of Nephrology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Keiji Shimazu (K)

Department of Nephrology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.

Tomofumi Moriyama (T)

Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.

Mai Sato (M)

Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan.

Tadashi Otsuka (T)

Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Kan Katayama (K)

Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Mie, Japan.

Wataru Shimabukuro (W)

Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

Takuya Fujimaru (T)

Department of Nephrology, St. Luke's International Hospital, 9-1 Akashi-Cho, Chuo-Ku, Tokyo, Japan.

Kenichiro Miura (K)

Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan.

Koichi Nakanishi (K)

Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

Shigeo Horie (S)

Department of Urology, Department of Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan.

Kengo Furuichi (K)

Department of Nephrology, Kanazawa Medical University, Ishikawa, Japan.

Hirokazu Okada (H)

Department of Nephrology, Saitama Medical University, Saitama, Japan.

Ichiei Narita (I)

Division of Clinical Nephrology and Rheumatology, Niigata University, Niigata, Japan.

Satoru Muto (S)

Department of Urology, Juntendo University Nerima Hospital, Tokyo, Japan. s-muto@juntendo.ac.jp.
ORCID: 0000-0002-5400-5195

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questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Benzazépines › Tolvaptan › Public support for patients with intractable...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Maladies génétiques congénitales › Ciliopathies › Polykystoses rénales › Polykystose rénale autosomique dominante › Public support for patients with intractable...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Antagonistes des récepteurs de l'hormone antidiurétique › Public support for patients with intractable...
questionsmedicales.fr › Régions géographiques › Iles › Japon › Public support for patients with intractable...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents cardiovasculaires › Antihypertenseurs › Public support for patients with intractable...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Public support for patients with intractable...