Asthma severity, poor control, co-morbidities and prior resource use determined omalizumab prescriptions in a nested case-control study with US claims data

Abstract Background Patients with peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) are more likely to receive long-term therapy with proton pump inhibitors (PPIs). This study aimed to investigate the risk of osteoporotic fractures in PPI users compared to histamine-2 receptor antagonist (H2RA) users and the association between fractures and the duration and regular use of PPI. Methods A population-based, nationwide nested case-control study from January 2006 to December 2015 was performed using Korean National Health Insurance Service claims data. We included patients ≥50 years of age, without previous fractures, newly prescribed with PPI or H2RA, and diagnosed with PUD or GERD from 2006 to 2015. Patients with osteoporotic fracture (n = 59,240) were matched with the non-fracture control group (n = 296,200) at a 1:5 ratio based on sex, age, cohort entry date, follow-up duration, and bisphosphonate use. The osteoporotic fractures were defined using the diagnostic codes of claims data (M80, M81, M82, M484, M485, S220, S221, S320, S327, S422, S423, S525, S526, S72). Results The higher the cumulative use of PPIs, the higher the osteoporotic fracture risk (P for trend < 0.001). The risk of osteoporotic fracture in the patients whose cumulative use of PPI was more than 1 year was higher than that of others (OR: 1.42, 95% CI: 1.32–1.52). Patients who regularly used PPI in the recent 1 year had a higher risk of osteoporotic fracture than exclusive H2RA users (OR: 1.37, 95% CI: 1.26–1.50). Conclusions The risk of osteoporotic fracture increased with the duration of PPI use, especially when PPI was used for ≥1 year and regularly in the recent 1 year.

Download Full-text

Childhood Asthma and COVID-19: A Nested Case-Control Study

10.1101/2021.09.20.21263838 ◽

2021 ◽

Author(s):

Kristina Gaietto ◽

Megan Culler Freeman ◽

Leigh Anne DiCicco ◽

Sherry Rauenswinter ◽

Joseph R Squier ◽

...

Keyword(s):

Case Control Study ◽

Symptom Control ◽

Asthma Severity ◽

Underlying Disease ◽

Case Control ◽

Individual Level ◽

Clinical Registries ◽

Using Data ◽

Nested Case Control ◽

Control Study

BACKGROUND: Most pediatric studies of asthma and COVID-19 to date have been ecological, which offer limited insight. We evaluated the association between asthma and COVID-19 at an individual level. METHODS: Using data from prospective clinical registries, we conducted a nested case-control study comparing three groups: children with COVID-19 and underlying asthma ("A+C" cases); children with COVID-19 without underlying disease ("C+" controls); and children with asthma without COVID-19 ("A+" controls). RESULTS: The cohort included 142 A+C cases, 1110 C+ controls, and 140 A+ controls. A+C cases were more likely than C+ controls to present with dyspnea and wheezing, to receive pharmacologic treatment including systemic steroids (all p<0.01), and to be hospitalized (4.9% vs 1.7%, p=0.01). In the adjusted analysis, A+C cases were nearly 4 times more likely to be hospitalized than C+ controls (adjusted OR=3.95 [95%CI=1.4-10.9]); however, length of stay and respiratory support level did not differ between groups. Among A+C cases, 8.5% presented with an asthma exacerbation and another 6.3% developed acute exacerbation symptoms shortly after testing positive for SARS-CoV-2. Compared to historic A+ controls, A+C cases had less severe asthma, were less likely to be on controller medications, and had better asthma symptom control (all p<0.01). CONCLUSIONS: In our cohort, asthma was a risk factor for hospitalization in children with COVID-19, but not for worse COVID-19 outcomes. SARS-CoV-2 does not seem to be a strong trigger for pediatric asthma exacerbations. Asthma severity was not associated with higher risk of COVID-19.

Download Full-text

The Association Between Dementia and Long-Term Use of Benzodiazepine in the Elderly: Nested Case–Control Study Using Claims Data

American Journal of Geriatric Psychiatry ◽

10.1097/jgp.0b013e3181a65210 ◽

2009 ◽

Vol 17 (7) ◽

pp. 614-620 ◽

Cited By ~ 85

Author(s):

Chi-Shin Wu ◽

Sheng-Chang Wang ◽

I-Shou Chang ◽

Keh-Ming Lin

Keyword(s):

Claims Data ◽

Case Control Study ◽

The Elderly ◽

Case Control ◽

Nested Case Control ◽

Control Study

Download Full-text

Comparative associations between anticholinergic burden and emergency department visits for anticholinergic adverse events in older Korean adults: a nested case-control study using national claims data for validation of a novel country-specific scale

BMC Pharmacology and Toxicology ◽

10.1186/s40360-020-00467-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sunghee Hwang ◽

Jee Eun Chung ◽

Kwanghee Jun ◽

Young-Mi Ah ◽

Kwang-Il Kim ◽

...

Keyword(s):

Emergency Department ◽

Urinary Retention ◽

Claims Data ◽

Case Control Study ◽

Case Control ◽

Korean Adults ◽

Ed Visits ◽

Nested Case Control ◽

Anticholinergic Burden ◽

Control Study

Abstracts Background Considering the limited generalizability of previous anticholinergic burden scales, the Korean Anticholinergic Burden Scale (KABS) as a scale specific to the Korean population was developed. We aimed to validate the KABS by detecting the associations between high anticholinergic burden, measured with the KABS, and emergency department (ED) visits compared to the pre-existing validated scales in older Korean adults. Methods A nested case-control study was conducted using national claims data. The cases included the first anticholinergic ED visits between July 1 and December 31, 2016. Anticholinergic ED visits were defined as ED visits with a primary diagnosis of constipation, delirium, dizziness, fall, fracture, or urinary retention. Propensity score-matched controls were identified. Average daily AB scores during 30 days before the index date were measured. Multivariate logistic regression analyses were performed. Results In total, 461,034 were included. The highest proportion of those with high AB was identified with KABS (5.0%). Compared with those who had a KABS score of 0, older adults with a score ≥ 3 were at higher risk for overall anticholinergic ED visits (aOR, 1.62, 95% CI, 1.53–1.72), as well as visits for falls/fractures (aOR: 1.54, 95% CI: 1.40–1.69), dizziness (aOR: 1.44, 95% CI: 1.30–1.59), delirium (aOR: 2.96, 95% CI: 2.28–3.83), constipation (aOR: 1.84, 95% CI: 1.68–2.02), and urinary retention (aOR: 2.13, 95% CI: 1.79–2.55). High AB by KABS showed a stronger association with overall anticholinergic ED visits and visits due to delirium and urinary retention than those by other scales. Conclusions In conclusion, KABS is superior to pre-existing scales in identifying patients with high AB and predicting high AB-related ED visits in older Korean adults.

Download Full-text