背景:缺乏抗痴呆药物(ADDs)的最新时间趋势分析。这项研究的目的是使用真实世界数据评估痴呆症患者的ADD发生率(IR)。
方法:来自英国/CPRD-GOLD(2007-20)的初级保健数据(国家/数据库),西班牙/SIDIAP(2010-20)和荷兰/IPCI(2008-20),标准化为通用数据模型。
方法:队列研究。参与者:年龄≥40岁的痴呆患者,既往数据≥1年。随访:直到研究期结束,转移出集水区,利伐斯的明死亡或事故处方,加兰他敏,多奈哌齐或美金刚.其他变量:年龄/性别,痴呆的类型,合并症.统计数据:总体和年度年龄/性别IR,95%的置信区间,每100,000人年(IR每105PY(95CI))。
结果:我们在UK/CPRD-GOLD中确定了总共(抗痴呆症患者/痴呆症患者)41,024/110,642,西班牙/SIDIAP为51667/134927,荷兰/IPCI为2088/17559。在英国,从2007年(30,829(28,891-32,862))到2010年(17,793(17,083-18,524)),然后增加到2019年(31,601(30,483至32,749)),并在2020年减少(24,067(23,021-25,148))。在西班牙,从2010年(51003(49199-52855))到2020年(14571(14109-15043)),ADD的IR(每105日元(95CI))下降了72%。在荷兰,从2009年(21,151(14,967-29,031))到2020年(4763(4176-5409)),ADD的IR(每105日元(95CI))下降了77%。年龄≥65-79岁的受试者和男性(在英国和荷兰)更频繁地开始ADD。
结论:痴呆的治疗仍然高度异质性。迫切需要在痴呆症患者的药理管理方面达成进一步共识。
An updated time-trend analysis of anti-dementia drugs (ADDs) is lacking. The aim of this study is to assess the incident rate (IR) of ADD in individuals with dementia using real-world data.
Primary care data (country/database) from the UK/CPRD-GOLD (2007-20), Spain/SIDIAP (2010-20) and the Netherlands/IPCI (2008-20), standardised to a common data model.
Cohort study. Participants: dementia patients ≥40 years old with ≥1 year of previous data. Follow-up: until the end of the study period, transfer out of the catchment area, death or incident prescription of rivastigmine, galantamine, donepezil or memantine. Other variables: age/sex, type of dementia, comorbidities. Statistics: overall and yearly age/sex IR, with 95% confidence interval, per 100,000 person-years (IR per 105 PY (95%CI)).
We identified a total of (incident anti-dementia users/dementia patients) 41,024/110,642 in UK/CPRD-GOLD, 51,667/134,927 in Spain/SIDIAP and 2,088/17,559 in the Netherlands/IPCI.In the UK, IR (per 105 PY (95%CI)) of ADD decreased from 2007 (30,829 (28,891-32,862)) to 2010 (17,793 (17,083-18,524)), then increased up to 2019 (31,601 (30,483 to 32,749)) and decrease in 2020 (24,067 (23,021-25,148)). In Spain, IR (per 105 PY (95%CI)) of ADD decreased by 72% from 2010 (51,003 (49,199-52,855)) to 2020 (14,571 (14,109-15,043)). In the Netherlands, IR (per 105 PY (95%CI)) of ADD decreased by 77% from 2009 (21,151 (14,967-29,031)) to 2020 (4763 (4176-5409)). Subjects aged ≥65-79 years and men (in the UK and the Netherlands) initiated more frequently an ADD.
Treatment of dementia remains highly heterogeneous. Further consensus in the pharmacological management of patients living with dementia is urgently needed.