Assessment of asthma severity according to treatment steps in Japanese pediatric patients: a descriptive cross-sectional study using an administrative claims database

Abstract

Objectives

Japan has one of the highest asthma prevalence rates in Asia; however, there is a lack of epidemiological studies on asthma among children in Japan. This study aimed to describe the severity of asthma and the prescription patterns for its treatment among pediatric patients, by using a large-scale claims database.

Methods

The analysis datasets were extracted from the JMDC database for the period of April 1, 2009 to March 30, 2015; included records were restricted to patients between 2 and 15 years of age. The Japanese Pediatric Guidelines for the treatment and management of asthma (JPGL) steps were used as a proxy for asthma treatment and severity. We also described the characteristics of asthma in children by stratifying the prevalence and incidence cohorts by index years.

Results

In the prevalence cohort (56% male), from 2010 to 2014, approximately 80–90% of the children received step 1 or 2 treatment, with the remainder receiving step 3 or 4 treatment, as defined by the JPGL. The majority (approximately 90%) of patients visited clinics for asthma treatment, while a minority visited hospitals.

Conclusions

Our study showed the severity of asthma among Japanese pediatric patients, as well as their demographic characteristics, using a large-scale claims database. The majority of pediatric asthma patients received treatment for mild-to-moderate asthma, while less than 10% received treatment for severe asthma.

Keywords:

• Asthma
• child
• claims database
• incidence
• prevalence
• treatment guideline
• pharmacoepidemiology

Declaration of interest

Hajime Yoshisue and Masanari Kozawa are company employees of Novartis Pharma K.K. Koji Kawakami received research funds from Sumitomo Dainippon Pharma Co., Ltd., Stella Pharma Corporation, CMIC Co., Ltd., Suntory Beverage & Food Ltd., Novartis Pharma K.K., and Bayer Yakunin Ltd.; consulting fees or speaker honoraria from Kyowa Hakko Kirin Co., Ltd., Kaken Pharmaceutical Co., Ltd., Astellas Pharma Inc., Mitsubishi Tanabe Pharma Co., AbbVie Inc., Santen Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Takeda Pharmaceutical Co., Ltd., Boehringer Ingelheim Japan, Inc., JMDC Inc., and Agree, Inc.; and is a stockholder of Real World Data Co., Ltd. Shiro Tanaka has received lecture fees from Bayer Yakuhin Ltd., Amgen Astellas BioPharma K.K., and Research Institute of Healthcare Data Science; a consultation fee from Boehringer Ingelheim Japan, Inc.; an outsourcing fee from the Public Health Research Foundation; and grants from the Japan Agency for Medical Research and Development, the Japanese Ministry of Health Labor and Welfare, and the Japanese Ministry of Education, Science, and Technology. He engaged in a research project by the Japan Agency for Medical Research and Development. Yuichi Adachi has received honoraria from GSK, MSD, and Kyorin Pharmaceutical Co., Ltd. The other author has no conflicts of interest to declare.

Funding

This study was conducted with financial support from Novartis Pharma K.K.