Disease-modifying drugs for multiple sclerosis and subsequent health service use.
Disease-modifying drugs for multiple sclerosis and subsequent health service use.
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DOI：
10.1177/13524585211063403
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Tremlett H
中科院分区：
文献类型：
--
作者：
Ng HS;Zhu F;Kingwell E;Zhao Y;Yao S;Ekuma O;Svenson LW;Evans C;Fisk JD;Marrie RA;Tremlett H
我们评估了多发性硬化症 (MS) 疾病缓解药物 (DMD) 与医疗保健使用之间的关系。使用加拿大四个省基于人口的相关健康管理数据来识别多发性硬化症患者（年龄≥18岁），并从最近的第一次多发性硬化症/脱髓鞘事件或1996年1月1日起进行追踪，直至死亡、移民或研究结束（2017年12月31日或2018年3月31日）中最早的事件。处方记录记录了 DMD 暴露情况，按任何 DMD 进行检查，然后按代（第一代（注射剂）或第二代（口服/输注））和个体 DMD 进行检查。使用比例均值模型和负二项式回归检查了与随后的全因住院和就诊的关联。在 35,894 例 MS 病例（72% 为女性）中，平均随访时间为 12.0 年，任何或任何第一代或第二代 DMD 暴露的人年分别为 63,290、54,605 和 8685。任何 DMD 或任何第一代 DMD 暴露（与未暴露）均与住院风险降低 24% 相关（调整后风险比，aHR：0.76；95% 置信区间 (CI)：0.71–0.82），第二代 DMD 则上升至 29%（aHR：0.71；95% CI：0.58–0.88）。其范围从特立氟胺的 18%（aHR：0.82；95% CI：0.67–1.00）到芬戈莫德的 44%（aHR：0.56；95% CI：0.36–0.87）。相比之下，DMD 暴露通常与就诊次数的显着差异无关。研究结果提供了真实世界的证据，证明 DMD 暴露与住院治疗之间存在有益关系。
We assessed the relationship between the multiple sclerosis (MS) disease-modifying drugs (DMDs) and healthcare use. Persons with MS (aged ⩾18 years) were identified using linked population-based health administrative data in four Canadian provinces and were followed from the most recent of their first MS/demyelinating event or 1 January 1996 until the earliest of death, emigration, or study end (31 December 2017 or 31 March 2018). Prescription records captured DMD exposure, examined as any DMD, then by generation (first-generation (the injectables) or second-generation (orals/infusions)) and individual DMD. The associations with subsequent all-cause hospitalizations and physician visits were examined using proportional means model and negative binomial regression. Of 35,894 MS cases (72% female), mean follow-up was 12.0 years, with person-years of DMD exposure for any, or any first- or second-generation DMD being 63,290, 54,605 and 8685, respectively. Any DMD or any first-generation DMD exposure (versus non-exposure) was associated with a 24% lower hazard of hospitalization (adjusted hazard ratio, aHR: 0.76; 95% confidence intervals (CIs): 0.71–0.82), rising to 29% for the second-generation DMDs (aHR: 0.71; 95% CI: 0.58–0.88). This ranged from 18% for teriflunomide (aHR: 0.82; 95% CI: 0.67–1.00) to 44% for fingolimod (aHR: 0.56; 95% CI: 0.36–0.87). In contrast, DMD exposure was generally not associated with substantial differences in physician visits. Findings provide real-world evidence of a beneficial relationship between DMD exposure and hospitalizations.
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影响因子：
11.2
作者：
Kalincik, Tomas;Horakova, Dana;Butzkueven, Helmut
通讯作者：
Butzkueven, Helmut
影响因子：
3.5
作者：
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影响因子：
2.1
作者：
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Watson, Crystal
影响因子：
9.9
作者：
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通讯作者：
Elliott, L.
影响因子：
5.8
作者：
Lorscheider, Johannes;Benkert, Pascal;Yaldizli, Ozgur
通讯作者：
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