Skip to main content

Advertisement

SpringerLink
Log in

Use of systemic corticosteroids in patients newly registered at a claims database with a diagnosis of non-infectious uveitis: results from a real-world claims database analysis

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the real-world dose of systemic corticosteroids in the treatment of non-infectious uveitis (NIU) in Japan.

Study design

A retrospective, observational study.

Methods

Patients newly registered at the Japan Medical Data Center health insurance claims database with a diagnosis of NIU who received systemic corticosteroids were identified, and their systemic corticosteroid dose (prednisolone equivalent) was assessed over 12 months of treatment (data extraction period: January 2008 to May 2017).

Results

The mean cumulative systemic corticosteroid dose in 12 months in 1641 new patients with NIU who received systemic corticosteroids was 593.7 mg. The mean systemic corticosteroid dose was highest at month 1 (10.7, 218.1, 16.7, and 23.0 mg/day in Behçet’s disease [BD]–associated NIU [n = 19], Vogt-Koyanagi-Harada [VKH] disease–associated NIU [n = 49], sarcoidosis-associated NIU [n = 27], and “undifferentiated NIU” [NIU without specific primary disease information, n = 1545], respectively) and decreased over time. Systemic corticosteroids were prescribed at month 12 to 68.4%, 22.4%, 44.4%, and 5.6% of patients with BD–associated NIU, VKH disease–associated NIU, sarcoidosis-associated NIU, and undifferentiated NIU, respectively (mean dose, 6.0–14.3 mg/day). Multivariate regression analysis identified female sex, middle age (30 to < 40 years), VKH disease, and immunosuppressive agent use as background factors associated with higher systemic corticosteroid dose.

Conclusions

The systemic corticosteroid dose was highest at month 1 and decreased over time in all disease categories. This database research revealed that some patients with NIU continued being prescribed systemic corticosteroids for at least 1 year.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Rothova A, Suttorp-van Schulten MS, Frits Treffers W, Kijlstra A. Causes and frequency of blindness in patients with intraocular inflammatory disease. Br J Ophthalmol. 1996;80:332–6.

    Article  CAS  Google Scholar 

  2. Dick AD, Tundia N, Sorg R, Zhao C, Chao J, Joshi A, et al. Risk of ocular complications in patients with noninfectious intermediate uveitis, posterior uveitis, or panuveitis. Ophthalmology. 2016;123:655–62.

    Article  Google Scholar 

  3. Iwase A, Araie M, Tomidokoro A, Yamamoto T, Shimizu H, Kitazawa Y, Tajimi Study Group. Prevalence and causes of low vision and blindness in a Japanese adult population: the Tajimi study. Ophthalmology. 2006;113:1354–62.

    Article  Google Scholar 

  4. Takeuchi M, Kanda T, Kaburaki T, Tanaka R, Namba K, Kamoi K, et al. Real-world evidence of treatment for relapse of noninfectious uveitis in tertiary centers in Japan: a multicenter study. Med (Baltim). 2019;98:e14668.

    Article  CAS  Google Scholar 

  5. Takahashi R, Yoshida A, Inoda S, Okubo A, Kawashima H. Uveitis incidence in Jichi Medical University Hospital, Japan, during 2011–2015. Clin Ophthalmol. 2017;11:1151–6.

    Article  Google Scholar 

  6. Kotake S, Furudate N, Sasamoto Y, Yoshikawa K, Goda C, Matsuda H. Characteristics of endogenous uveitis in Hokkaido, Japan. Graefes Arch Clin Exp Ophthalmol. 1996;234:599–603.

    Article  CAS  Google Scholar 

  7. Hikita S, Sonoda KH, Hijioka K, Fujimoto T, Ito T, Ishibashi T. Incidence of uveitis in the northern Kyushu region of Japan–comparison between the periods of 1996–2001 and 2003–2008. Nippon Ganka Gakkai zasshi. 2012;116:847–55. [in Japanese].

    PubMed  Google Scholar 

  8. Iwata D, Mizuuchi K, Aoki K, Horie Y, Kase S, Namba K, et al. Serial frequencies and clinical features of uveitis in Hokkaido, Japan. Ocul Immunol Inflamm. 2017;25(Sup 1):15–8.

    Article  Google Scholar 

  9. Nakahara H, Kaburaki T, Takamoto M, Okinaga K, Matsuda J, Konno Y, et al. Statistical analyses of endogenous uveitis patients (2007–2009) in central Tokyo area and comparison with previous studies (1963–2006). Ocul Immunol Inflamm. 2015;23:291–6.

    Article  Google Scholar 

  10. Nakahara H, Kaburaki T, Tanaka R, Takamoto M, Ohtomo K, Karakawa A, et al. Frequency of uveitis in the central Tokyo area (2010–2012). Ocul Immunol Inflamm. 2017;25(Sup 1):8–14.

    Article  Google Scholar 

  11. Shirahama S, Kaburaki T, Nakahara H, Tanaka R, Takamoto M, Fujino Y, et al. Epidemiology of uveitis (2013–2015) and changes in the patterns of uveitis (2004–2015) in the central Tokyo area: a retrospective study. BMC Ophthalmol. 2018;18:189.

    Article  Google Scholar 

  12. Ohguro N, Sonoda KH, Takeuchi M, Matsumura M, Mochizuki M. The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol. 2012;56:432–5.

    Article  Google Scholar 

  13. Goto H, Mochizuki M, Yamaki K, Kotake S, Usui M, Ohno S. Epidemiological survey of intraocular inflammation in Japan. Jpn J Ophthalmol. 2007;51:41–4.

    Article  Google Scholar 

  14. Japanese Ocular Inflammation Society. Guideline for treatment of uveitis (June 10, 2019). Nippon Ganka Gakkai zasshi. 2019;123:635–96. [in Japanese].

    Google Scholar 

  15. Mishima S, Masuda K, Izawa Y, Mochizuki M, Namba K. The eighth Frederick H. Verhoeff lecture. Behçet’s disease in Japan: ophthalmologic aspects. Trans Am Ophthalmol Soc. 1979;77:225–79.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Committee for the Preparation of Clinical Treatment of Ocular Lesions Related to Behçet’s Disease. Guidelines for the clinical management of ocular Behçet’s disease. Nippon Ganka Gakkai zasshi. 2012;116:394–426. [in Japanese].

    Google Scholar 

  17. Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. N Engl J Med. 1999;341:1284–91.

    Article  CAS  Google Scholar 

  18. Herbort CP Jr, Abu El Asrar AM, Yamamoto AM, Pavésio JH, Gupta CE, Khairallah VM, et al. Reappraisal of the management of Vogt-Koyanagi-Harada disease: sunset glow fundus is no more a fatality. Int Ophthalmol. 2017;37:1383–95.

    Article  Google Scholar 

  19. Japan Society of Sarcoidosis and other Granulomatous Disorders. Guidance on sarcoidosis treatment. 2018. https://www.jssog.com/journal. Accessed 1 February 2022. [in Japanese].

  20. Rice JB, White AG, Scarpati LM, Wan G, Nelson WW. Long-term systemic corticosteroid exposure: a systematic literature review. Clin Ther. 2017;39:2216–29.

    Article  CAS  Google Scholar 

  21. Yasir M, Goyal A, Bansal P, Sonthalia S. Corticosteroid adverse effects. Treasure Island (FL): StatPearls Publishing LLC; 2021.

    Google Scholar 

  22. Strehl C, Bijlsma JWJ, de Wit M, Boers M, Caeyers N, Cutolo M, et al. Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations: viewpoints from an EULAR task force. Ann Rheum Dis. 2016;75:952–7.

    Article  CAS  Google Scholar 

  23. Nakahara H, Kaburaki T, Tanaka R, Yoshida A, Takamoto M, Kawata M, et al. Comparisons of clinical features in Japanese patients with Behçet’s uveitis treated in the 1990s and the 2000s. Ocul Immunol Inflamm. 2020;28:262–9.

    Article  CAS  Google Scholar 

  24. Umazume A, Ohguro N, Okada AA, Namba K, Sonoda K, Tsuruga H, et al. Prevalence and incidence rates and treatment patterns of non-infectious uveitis in Japan: real-world data using a claims database. Jpn J Ophthalmol. 2021;65:657–65.

    Article  Google Scholar 

  25. Kimura S, Sato T, Ikeda S, Noda M, Nakayama T. Development of a database of health insurance claims: standardization of disease classifications and anonymous record linkage. J Epidemiol. 2010;20:413–9.

    Article  Google Scholar 

  26. Statistics Bureau, Ministry of Internal Affairs and Communications. Result of the Population Estimates. https://www.stat.go.jp/english/data/jinsui/2.html. Accessed 1 February 2022.

  27. O’Keefe GAD, Rao NA. Vogt-Koyanagi-Harada disease. Surv Ophthalmol. 2017;62:1–25.

    Article  Google Scholar 

  28. Grossmann C, Scholz T, Rochel M, Bumke-Vogt C, Oelkers W, Pfeiffer AFH, et al. Transactivation via the human glucocorticoid and mineralocorticoid receptor by therapeutically used steroids in CV-1 cells: a comparison of their glucocorticoid and mineralocorticoid properties. Eur J Endocrinol. 2004;151:397–406.

    Article  CAS  Google Scholar 

  29. Medical Care Act. Law number: Act No. 205 of 1948. https://www.mhlw.go.jp/web/t_doc?dataId=80090000&dataType=0&pageNo=1. Accessed 1 February 2022. [in Japanese].

  30. Sonoda KH, Hasegawa E, Namba K, Okada AA, Ohguro N, Goto H. JOIS (Japanese Ocular Inflammation Society) Uveitis Survey Working Group. Epidemiology of uveitis in Japan: a 2016 retrospective nationwide survey. Jpn J Ophthalmol. 2021;65:184–90.

    Article  Google Scholar 

  31. Sakai JI, Usui Y, Sakai M, Yokoi H, Goto H. Clinical statistics of endogenous uveitis: comparison between general eye clinic and university hospital. Int Ophthalmol. 2010;30:297–301.

    Article  Google Scholar 

  32. Wang Y, Chan CC. Gender differences in Vogt-Koyanagi-Harada disease and sympathetic ophthalmia. J Ophthalmol. 2014;2014:157803.

    PubMed  PubMed Central  Google Scholar 

  33. Vander Cruyssen B, Ribbens C, Boonen A, Mielants H, de Vlam K, Lenaerts J, et al. The epidemiology of ankylosing spondylitis and the commencement of anti-TNF therapy in daily rheumatology practice. Ann Rheum Dis. 2007;66:1072–7.

    Article  Google Scholar 

  34. Sabri K, Saurenmann RK, Silverman ED, Levin AV. Course, complications, and outcome of juvenile arthritis-related uveitis. J AAPOS. 2008;12:539–45.

    Article  Google Scholar 

  35. Stuck AE, Frey BM, Frey FJ. Kinetics of prednisolone and endogenous cortisol suppression in the elderly. Clin Pharmacol Ther. 1988;43:354–62.

    Article  CAS  Google Scholar 

  36. Shionogi & Co., Ltd. Predonine® 5 mg tablets Japanese package insert, version 1 (revised. July 2020). https://www.info.pmda.go.jp/go/pack/2456001F1310_4_02/. Accessed 1 February 2022. [in Japanese].

  37. Nishimura R, Kato H, Kisanuki K, Oh A, Hiroi S, Onishi Y, et al. Treatment patterns, persistence and adherence rates in patients with type 2 diabetes mellitus in Japan: a claims-based cohort study. BMJ Open. 2019;9:e025806.

    Article  Google Scholar 

  38. Japanese Ophthalmological Society. Guidance and safety manual on the use of anti-TNF agents in non-infectious uveitis (revised version 2). Nippon Ganka Gakkai zasshi. 2019;123:697–705. [in Japanese].

    Google Scholar 

Download references

Acknowledgements

This work was funded by AbbVie GK. AbbVie GK participated in the study design, data analysis and interpretation, and writing, reviewing, and approval of the publication. We thank Prof. Ishikawa of International University of Health and Welfare for his contribution as an advisor and database study expert and Motohiro Okayasu, Yoko Yoshinaga, and Masahiko Nakayama, past or current AbbVie employees, for their contribution to the design of this study. Data extraction and statistical analyses were performed by JMDC Co. Ltd. and funded by AbbVie GK. Medical writing support was provided by Mami Hirano, MS, of Cactus Life Sciences (part of Cactus Communications) and funded by AbbVie GK.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan

    Akihiko Umazume & Hiroshi Goto

  2. Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan

    Nobuyuki Ohguro

  3. Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan

    Annabelle A. Okada

  4. Department of Ophthalmology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Kenichi Namba

  5. Department of Clinical Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan

    Koh-Hei Sonoda

  6. AbbVie GK, 3-1-21 Shibaura, Minato-ku, 108-0023, Tokyo, Japan

    Hidekazu Tsuruga & Kazuo Morita

Authors
  1. Akihiko Umazume
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nobuyuki Ohguro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annabelle A. Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenichi Namba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koh-Hei Sonoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hidekazu Tsuruga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kazuo Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hidekazu Tsuruga.

Ethics declarations

Conflicts of interest

A. Umazume, None; N. Ohguro, None; A. A. Okada, Grants (Bayer, Novartis, Santen, Mitsubishi Tanabe, Alcon, Kowa), Consulting fees (Bayer, AbbVie, Astellas, Biocon Biologics, Daiichi Sankyo, Allergan, Chugai, Novartis), Speaker fees (Bayer, Kowa, Novartis, Santen, Mitsubishi Tanabe, Senju, Alcon, Otsuka, Allergan); K. Namba, Grant (AbbVie, Mitsubishi Tanabe, Eisai, EP-CRSU), Speaker fees (Alcon, Pfizer, Novartis, Kowa, Senju, Mitsubishi Tanabe, Eisai, AbbVie, Santen, Celgene); K. Sonoda, None; H. Goto, None; H. Tsuruga and K. Morita are employees of AbbVie GK and may receive stocks.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding Author: Hidekazu Tsuruga

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1 (333 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Umazume, A., Ohguro, N., Okada, A.A. et al. Use of systemic corticosteroids in patients newly registered at a claims database with a diagnosis of non-infectious uveitis: results from a real-world claims database analysis. Jpn J Ophthalmol 66, 394–404 (2022). https://doi.org/10.1007/s10384-022-00923-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-022-00923-2

Keywords

Search

Navigation