Publications by authors named "Kosuke Iwasaki"

Objective: To investigate the opioid prescription status around clinical events among patients with breast cancer in Japan using a comprehensive claims database.

Methods: This was a retrospective cohort study using the National Database (April 2009-March 2020). The target patients had a first breast cancer diagnosis in April 2010 or later.

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Background: Although intravitreal anti-vascular endothelial growth factor therapy is currently considered the first-line treatment for chorioretinal vascular diseases in Japan, information regarding its treatment pattern is scarce. This study investigated the patterns of anti-vascular endothelial growth factor treatment for chorioretinal vascular diseases.

Methods: A health insurance claims database from acute care hospitals was used to estimate treatment intervals and continuation and drop-out rates regarding the anti-vascular endothelial growth factor.

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Aims: To investigate the prevalence, treatment status, and effect of anemia on medical costs, quality of life (QOL), and productivity loss in Japan.

Methods: This cross-sectional study used a database containing claims, health check-ups, and questionnaire data. Adults with hemoglobin data at 2020 check-ups were included.

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Article Synopsis
  • The study aimed to explore the preferences of the Japanese public regarding government policies to manage infectious disease outbreaks.
  • A survey, using conjoint analysis with 2,185 respondents, found that accessibility to therapeutic drugs, tests, and vaccines was highly valued, with drug accessibility having the highest estimated monetary value of JPY 10.5 trillion.
  • The findings indicated a clear preference for accessibility of medical resources over behavioral or entry restrictions during the ongoing COVID-19 pandemic, although the sample may not fully represent the broader population.
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Introduction: During the recent coronavirus disease 2019 (COVID-19) pandemic, preferences for factors associated with vaccines have been evaluated. Three oral antiviral drugs have been approved in Japan for patients with mild-to-moderate I COVID-19 symptoms. Although preferences for the drugs may also depend on various factors, these have not been fully evaluated.

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Purpose: Breast cancer is the most common cancer among Japanese women and often yields a better prognosis than other cancers. However, few studies have been conducted on pain control using opioids in Japan. In this study, we aimed to examine actual opioid use among breast cancer patients.

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Purpose: Heart failure (HF) is a serious public health burden that is rapidly increasing in the aging population. Valvular heart disease (VHD) is a known etiology of heart failure (HF); however, the impact of VHD on outcomes of patients with HF has not been well-studied in Japan. This study aimed to determine the rates of VHD in Japanese patients admitted for HF and explore associations of VHD with in-hospital outcomes through a claim-based analysis.

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Background: Dipeptidyl peptidase-4 inhibitors (DPP4is) and metformin are the most frequently prescribed first-line drugs for Japanese patients with type 2 diabetes (T2D). We investigated the risk of cardiovascular events by second-line treatment type in these patients.

Research Design And Methods: Patients with T2D, prescribed either metformin or DPP4i as a first-line drug, were identified in claims data from Japanese acute care hospitals.

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Background: Valvular heart disease (VHD) is one of the commonest causes of cardiovascular morbidity and mortality worldwide, with acquired VHD especially prevalent in countries with aging populations. The scope and pattern of disease are not well understood, as some patients are asymptomatic and available options for invasive treatment vary by affected valve. We sought to understand the burden of VHD in Japan including the distribution of patients by valve disease type and age, using administrative claims data from acute care hospitals.

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Aims: This study aimed to estimate the utility values of the factors associated with intravenous (IV) iron infusion treatment in Japanese patients with iron-deficiency anemia (IDA) from the patient's perspective.

Methods: A conjoint analysis based on online survey data was conducted in May 2022 (registration number: UMIN000047756). Respondents in the main group were selected from the general population (20-69 years).

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Background: Treatment for idiopathic pulmonary fibrosis (IPF) has changed over the past decades. Understanding the actual status of IPF treatment and evaluating the consistency of the guidelines are important for improving the treatment strategy. However, the relevant information is insufficient in Japan.

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Background: Acute exacerbation is an essential prognostic factor in idiopathic pulmonary fibrosis (IPF) and is the leading cause of death in Japanese patients with IPF. Its epidemiology, treatment status, and effect on IPF progression have been insufficiently investigated. We examined the incidence of acute exacerbation and treatment status before and after the onset of acute exacerbation in Japanese patients with IPF to provide basic information for treatment strategies.

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Article Synopsis
  • Repeated hospitalizations in heart failure patients are linked to worse symptoms and prognosis, but they don't necessarily increase in-hospital mortality.
  • A study in Japan analyzed data from over 49,000 heart failure patients to explore the clinical and financial impacts of repeat hospitalizations from 2013 to 2018.
  • The findings revealed that while hospitalization costs are high (averaging over ¥564,000 per patient), more frequent hospital stays lead to shorter intervals between them, indicating a decline in patient health and increased financial strain.
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Introduction: The healthcare situation of multiple sclerosis (MS) and its course are not being thoroughly investigated in Japan. We aimed to examine the current healthcare situation, including treatment and healthcare costs, of MS according to duration since its first diagnosis using Japanese real-world data to determine unidentified healthcare issues at each disease stage.

Methods: This retrospective, non-comparative, non-interventional study used a Japanese nationwide claims database (April 2008-August 2018) comprising 20 million patients from 329 acute care hospitals (as of June 2018).

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Medical practices for influenza virus infection vary among countries. In Japan, treatment with anti-influenza drugs is recommended for patients diagnosed with influenza. This health claims database study provides quantitative information aimed at describing the actual medical practices, including diagnostic testing and medication use, for managing influenza in Japan.

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Objectives: To compare the risk of cardiovascular events from the initiation of therapy between metformin and dipeptidyl peptidase-4 inhibitors (DPP-4i) as first-line therapy.

Design: Retrospective cohort study using two claims databases.

Setting: The MDV database (provided by Medical Data Vision) comprised data from acute care hospitals, and the JMDC database (provided by JMDC) comprised data from individuals covered by health insurance societies.

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Article Synopsis
  • The study evaluates the inconvenience costs of influenza antivirals for children in Japan by analyzing parent feedback on different drug characteristics.
  • An online survey collected data from parents of 6-11 year olds who had used antivirals, focusing on various drug forms (tablet, capsule, etc.), administration frequency, and costs.
  • Results showed that tablets were the preferred option, with other forms incurring higher inconvenience costs, highlighting that single-dose tablets are optimal for minimizing issues during treatment.
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Background: Idiopathic pulmonary fibrosis (IPF) is a cryptogenic chronic interstitial pneumonia with progressive fibrosis and a poor prognosis. A substantial number of epidemiological studies have been conducted in Europe and the United States (US). In contrast, in Japan, only one study reported the prevalence of IPF (10.

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  • Japanese claims databases are useful for researching multiple sclerosis (MS), but they lack information on disease severity and disability.
  • The study developed a MS severity score using principal component analysis (PCA), analyzing data from 7067 MS patients and correlating this score with factors like age, gender, and disease duration.
  • The findings suggest that the new PC1 score aligns with previous research on MS severity, but more validation is needed using clinical measures like the Expanded Disability Status Scale (EDSS).
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Introduction: Thrombocytopenia, a common complication of chronic liver disease (CLD), adversely affects the treatment in patients requiring invasive procedures. Multiple pathophysiological mechanisms contribute to the development of thrombocytopenia; thus, its incidence could differ among CLD etiologies. We investigated the risk of decline in platelet counts and developing thrombocytopenia across different CLDs in a real-world Japanese setting.

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Introduction: Although metformin is recommended as a first-line treatment for patients with type 2 diabetes (T2D) in Western countries, no specific treatment is recommended in Japan, and various agents are used. Metformin has long been used at low doses in Japan, and information regarding its effect at the maximum maintenance dose is lacking. Here, we compared the efficacy and safety of metformin at 1500 mg/day with those of the other oral anti-diabetic drugs (OADs) approved in Japan.

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Aims: To estimate the cost of antiviral medication guidance and/or support from the perspective of healthcare professionals by administration route (oral or inhalant).

Methods: An online survey (December 2020) was conducted among physicians, pharmacists, and certified care workers. Those aged 20-64 years working in workplaces with experience of prescribing (physicians) or dispensing (pharmacists) antivirals for influenza, or having care service recipients who took antivirals (certified care workers) since October 2018, were selected through screening questions.

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Introduction: Thrombocytopenia can increase the bleeding risk in patients with chronic liver disease (CLD) undergoing invasive procedures. Prophylactic platelet transfusion (PT) is often performed to increase platelet counts in patients with CLD undergoing invasive procedures to prevent bleeding. Lusutrombopag, a small-molecule thrombopoietin receptor agonist, is expected to be an alternative therapy to prophylactic PT.

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Introduction: Metformin has demonstrated favorable effects on glycemic control in patients with type 2 diabetes (T2D), regardless of the body mass index (BMI). On the contrary, dipeptidyl peptidase-4 inhibitors (DPP-4is) are reportedly less effective in patients having high BMI values (≥ 25 or ≥ 30). The aim of this study was to compare metformin and DPP-4is as first-line treatment for their effects on glycemic control and improvement of other health outcomes among obese and non-obese Japanese patients with T2D.

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Introduction: Patients with type 2 diabetes (T2D) in Japan are prescribed a lower dose of metformin that their counterparts in Western countries due to concerns for the risk of lactic acidosis incidence. Here we report our study on the association between high-dose metformin administration and the incidence of lactic acidosis in Japanese patients with T2D.

Methods: A Japanese claims database (April 2008-November 2018) was analyzed.

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