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

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

Tatsuya Noda  1 , Kotaro Kuwaki  2   3 , Munehito Machida  4 , Yasuyuki Okumura  5 , Yuichi Nishioka  1 , Tomoya Myojin  1 , Tomoaki Imamura  1
Affiliations

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

Tatsuya Noda et al. PLoS One. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Design diagram: Definition of the inclusion and exclusion of monitored patients and the termination of prescription.
5-ASA, 5-aminosalicylic acid.
Fig 2
Fig 2. Flowchart of patient selection.
5-ASA, 5-aminosalicylic acid; SASP, salazosulfapyridine; UC, ulcerative colitis.
Fig 3
Fig 3. Distribution of starting year by 5-ASA (5-aminosalicylic acid) subtype.
*Data correspond to a 6-month period (April 2019 to September 2019). MMX, multi-matrix system.
Fig 4
Fig 4. Persistence of 5-ASA (5-aminosalicylic acid).
5-ASA, 5-aminosalicylic acid; MMX, multi-matrix system.
See this image and copyright information in PMC

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