Burden of Herpes Zoster in Adult Patients with Underlying Conditions: Analysis of German Claims Data, 2007-2018.
Burden of Herpes Zoster in Adult Patients with Underlying Conditions: Analysis of German Claims Data, 2007-2018.
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DOI：
10.1007/s13555-021-00535-7
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发表时间：
2021-06
影响因子：
3.4
通讯作者：
Greiner W
中科院分区：
文献类型：
--
作者：
Batram M;Witte J;Schwarz M;Hain J;Ultsch B;Steinmann M;Bhavsar A;Wutzler P;Criée CP;Hermann C;Wahle K;Füchtenbusch M;Greiner W
已知几种慢性潜在疾病（UCs）是发展带状疱疹（HZ）的危险因素，并增加HZ的严重程度及其复发风险。本研究的目的是调查成人单发或多发UCs患者HZ的发病率和复发率。基于2007年至2018年德国13%的法定医疗保险人口的索赔数据，进行了一项回顾性队列研究。年龄≥18岁的患者被诊断为以下UCs中的至少一种：哮喘、慢性心力衰竭、慢性阻塞性肺疾病（COPD）、冠心病（CHD）、抑郁症、1型或2型糖尿病和类风湿性关节炎（RA）。使用精确匹配来解释病例和匹配对照队列之间年龄和性别分布的差异。通过分析只有一种UC的患者，在敏感性分析中考虑了多发病。与没有UC的患者相比，患有哮喘、冠心病、慢性阻塞性肺病、抑郁症和RA的患者发生急性HZ的风险平均增加30%。在这些疾病中，RA的优势比最高，所有年龄组的优势比从1.37到1.57不等。抑郁症患者发展为HZ的风险也很高。复发分析表明，18-49岁和50-59岁年龄组中至少有一种UC的患者复发性HZ的风险最高。在经历第一次复发后，患者，无论年龄组，第二次复发的风险要高2 - 3倍。本研究的代表性索赔数据显示，UCs患者HZ发病率和复发率较高。这些结果为国家卫生保健指南和疾病管理计划提供了相关信息。在线版本包含补充材料，可在10.1007/s13555-021-00535-7获得。带状疱疹是由水痘病毒的再激活引起的，其特征是疼痛的皮肤皮疹和水疱，通常发生在躯干。潜在条件（UCs）是持续很长时间的条件，需要持续的医疗护理，并且很少完全治愈（慢性病）。UCs可以增加带状疱疹的严重程度、风险和频率。在这里，来自德国一家大型医疗保险公司的数据被用来调查患有一个或多个UCs的患者是否比健康人患带状疱疹的风险更高。特别是哮喘、慢性心力衰竭、慢性阻塞性肺疾病、冠心病、抑郁症、糖尿病和类风湿关节炎患者。研究表明，患有哮喘、冠心病、慢性阻塞性肺病、抑郁症和类风湿关节炎的患者，无论年龄大小，患带状疱疹的风险平均高出30%。至少有一次UC的患者发生两次或更多次带状疱疹的风险也更高，年龄在18-59岁的患者风险更大。研究发现，UC患者更容易患带状疱疹，年轻患者复发的风险更高。这些发现为制定或调整国家卫生保健指南和带状疱疹疫苗接种建议提供了重要信息。在线版本包含补充材料，可在10.1007/s13555-021-00535-7获得。
Several chronic underlying conditions (UCs) are known to be risk factors for developing herpes zoster (HZ) and to increase the severity of HZ and its risk of recurrence. The aim of this study was to investigate the incidence and recurrence of HZ in adult patients with one or multiple UCs. A retrospective cohort study based on claims data representing 13% of the statutory health insurance population from 2007 to 2018 in Germany was performed. Patients aged ≥ 18 years were included when at least one of the following UCs was diagnosed: asthma, chronic heart failure, chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), depression, diabetes mellitus type 1 or 2, and rheumatoid arthritis (RA). Exact matching was used to account for differences in the distribution of age and sex between the case and matched control cohorts. Multi-morbidity was considered in sensitivity analyses by analyzing patients with only one UC. Patients with asthma, CHD, COPD, depression, and RA had, on average, a 30% increased risk of developing acute HZ compared to patients without any UC. RA was found to have the highest odds ratio among these conditions, varying from 1.37 to 1.57 for all age groups. Patients with depression also showed a high risk of developing HZ. Analysis of recurrence indicated that patients with at least one UC in the age groups 18–49 years and 50–59 years had the highest risk for a recurrent HZ. After experiencing a first recurrence, patients, regardless of age group, had a two- to threefold higher risk for a second recurrence. This study of representative claims data shows a higher HZ incidence and recurrence frequency in patients with UCs. These results provide relevant information for national health care guidelines and disease management programs. The online version contains supplementary material available at 10.1007/s13555-021-00535-7. Shingles is caused by the reactivation of the chickenpox virus and is characterized by a painful skin rash with blisters, commonly occurring on the trunk. Underlying conditions (UCs) are conditions that persist for a long time, require ongoing medical attention, and are rarely completely cured (chronic conditions). UCs can increase the severity, the risk, and the frequency of shingles. Here, data from a large German health care insurance provider was used to investigate whether patients with one or more UCs have a higher risk for getting shingles compared to healthy people. In particular, patients with asthma, chronic heart failure, chronic obstructive pulmonary disease, coronary heart disease, depression, diabetes, and rheumatoid arthritis were investigated. The study shows that patients with asthma, coronary heart disease, chronic obstructive pulmonary disease, depression, and rheumatoid arthritis have, on average, a 30% higher risk of developing shingles, regardless of their age. The risk of developing shingles two or more times is also higher for patients with at least one UC, with those aged 18–59 experiencing an even greater risk. It was found that patients with an UC are more exposed to develop shingles and that younger patients have a higher risk of a recurrent episode. The findings provide important information for the development or adaption of national health care guidelines and shingles vaccination recommendations. The online version contains supplementary material available at 10.1007/s13555-021-00535-7.
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DOI：
10.1056/nejmcp1302674
发表时间：
2013-07-18
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen JI
通讯作者：
Cohen JI
影响因子：
7.5
作者：
Heymann, A. D.;Chodick, G.;Shalev, V.
通讯作者：
Shalev, V.
影响因子：
8.8
作者：
Lasserre, Andrea;Blaizeau, Fanette;Hanslik, Thomas
通讯作者：
Hanslik, Thomas
影响因子：
4.8
作者：
Esteban-Vasallo, Maria D.;Felicitas Dominguez-Berjon, M.;Gil de Miguel, Angel
通讯作者：
Gil de Miguel, Angel
影响因子：
8.9
作者：
Joesoef, Riduan M.;Harpaz, Rafael;Bialek, Stephanie R.
通讯作者：
Bialek, Stephanie R.