PDF(Pubmed)
Abstract：
Purpose: Inhaled Corticosteroids (ICSs) and oral Leukotriene Receptor Antagonists (LTRAs) are commonly prescribed asthma preventers, however, concerns have been raised as to whether montelukast (LTRA) is associated with an increase in occurrences of neuropsychiatric side effects in children. Our study was conducted to observe prescribing patterns of asthma preventers among paediatric patients specifically focusing on ICSs and LTRAs between Australia and South Korea to see intercountry differences in the use of these medicines. Materials and Methods: The Health Insurance Review and Assessment Paediatric Patients Sample dataset for South Korea and data provided by Services Australia were used in the study. Paediatric patients aged between 3 and 19 with more than one dispensing of an asthma preventer and at least one reliever between 1 Jan 2018 and 31 December 2018 were selected. Prevalence per 1,00,000 persons and standardised prevalence were estimated. Results: A total of 3,58,470 patients (2,04,270 from South Korea and 1,54,200 from Australia) were included in the study. A higher prevalence of ICS-based inhalers was seen in Australia with 80.1% compared to 13.5% in South Korea. In addition, Australia showed a stronger tendency of prescribing high dose ICS-based inhalers compared to South Korea with 22.9% vs. 4.9%. In contrast, use of LTRAs was more prevalent in South Korea with 57.6% while in Australia, montelukast was the only LTRA dispensed at a proportion of 18.9%. Moreover, 29.9% of xanthines which are orally available preventers, were prescribed more frequently in South Korea compared to Australia (0.1%). Conclusion: Australia showed a tendency of prescribing ICS-based preventers whereas South Korea exhibited a preference towards the oral LTRAs. Given the potential risk of neuropsychiatric side effects among paediatric patients with montelukast, reasons for the high use of montelukast in South Korea should be investigated further.
摘要：
目的：吸入糖皮质激素（ICSs）和口服白三烯受体拮抗剂（LTRAs）是常用的哮喘预防药物，然而,有人担心孟鲁司特(LTRA)是否与儿童神经精神副作用的发生率增加有关.进行我们的研究是为了观察儿科患者中哮喘预防者的处方模式，特别是澳大利亚和韩国之间的ICSs和LTRA，以观察这些药物使用的国家间差异。材料和方法：研究中使用了韩国的健康保险审查和评估儿科患者样本数据集以及澳大利亚服务提供的数据。选择年龄在3至19岁之间的儿科患者，在2018年1月1日至2018年12月31日之间分配了多于一种哮喘预防剂和至少一种缓解剂。估计了每1,000人的患病率和标准化患病率。结果：共有3,58,470例患者（韩国2,04,270例，澳大利亚1,54,200例）被纳入研究。在澳大利亚，基于ICS的吸入器的患病率更高，为80.1％，而在韩国为13.5％。此外,与韩国相比，澳大利亚显示出更强的处方高剂量基于ICS的吸入器的趋势，为22.9％。4.9%。相比之下,LTRA的使用在韩国更为普遍，为57.6%，而在澳大利亚，孟鲁司特是唯一的LTRA，比例为18.9%。此外，29.9%的黄嘌呤是口服可用的预防剂，与澳大利亚相比，韩国的处方频率更高（0.1%）。结论：澳大利亚显示出处方基于ICS的预防药的趋势，而韩国则倾向于口服LTRA。鉴于孟鲁司特儿科患者存在神经精神副作用的潜在风险，孟鲁司特在韩国大量使用的原因应该进一步调查。
