Persistence of newly prescribed 5-aminosalicylic acid in patients with ulcerative colitis: A nationwide comprehensive database study

PLoS One. 2024 Dec 30;19(12):e0316181. doi: 10.1371/journal.pone.0316181. eCollection 2024.

Abstract

The 5-aminosalicylic acid (5-ASA) agents are first-line drugs for ulcerative colitis (UC). However, intolerance as well as other issues have been reported for these drugs, making it difficult to sustain this treatment; accordingly, the persistence of 5-ASA is an important indicator of UC treatment strategy. We aimed to analyze the persistence of 5-ASA in patients with UC in Japan. This was a 1-year, nationwide, population-based cohort study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. We identified patients who were assigned UC-related disease codes and newly prescribed 5-ASA between April 2015 and September 2019 and specified the number of days until 5-ASA prescriptions were interrupted during a follow-up of up to 365 days. Among the 137 million patients who were covered by the universal health insurance in Japan during the study period, 68,234 eligible patients were identified. The 5-ASA persistence in these patients were 87.2%, 65.6%, and 56.4% after 30, 180, and 365 days, respectively. The 5-ASA persistence by subtype at 365 days was 54.4%, 56.4%, and 57.6% for time-dependent, pH-dependent, and multi-matrix system types, respectively. The 5-ASA persistence rate after 365 days was 65.0% for those under 20 years of age, 51.0% for those 20-39 years old, 57.5% for those 40-64 years old, and 65.5% for those over 64 years of age. This study revealed the 1-year persistence of newly prescribed 5-ASA in patients with UC newly prescribed 5-ASA in Japan, based on a national claims database of more than 100 million individuals.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Cohort Studies
  • Colitis, Ulcerative* / drug therapy
  • Databases, Factual*
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Mesalamine* / therapeutic use
  • Middle Aged
  • Young Adult

Substances

  • Mesalamine
  • Anti-Inflammatory Agents, Non-Steroidal

Grants and funding

Initials of the authors who received the award: TN Grant numbers awarded to each author: JP20H00623 The full name of each funder: JSPS KAKENHI URL of each funder website: https://www.jsps.go.jp/english/e-grants/ Did the sponsors or funders play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript? The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Initials of the authors who received the award: TN Grant numbers awarded to each author: H30-nanchitou-Ippan-019 The full name of each funder: Health Labour Sciences Research Grant URL of each funder website: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/hokabunya/kenkyujigyou/index.html Did the sponsors or funders play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript? The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.