{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:35:30Z","timestamp":1759336530261,"version":"3.32.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI `","award":["JP20H00623"],"award-info":[{"award-number":["JP20H00623"]}]},{"name":"Health Labour Sciences Research Grant","award":["H30-nanchitou-Ippan-019"],"award-info":[{"award-number":["H30-nanchitou-Ippan-019"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The 5-aminosalicylic acid (5-ASA) agents are first-line drugs for ulcerative colitis (UC). However, intolerance as well as other issues have been reported for these drugs, making it difficult to sustain this treatment; accordingly, the persistence of 5-ASA is an important indicator of UC treatment strategy. We aimed to analyze the persistence of 5-ASA in patients with UC in Japan. This was a 1-year, nationwide, population-based cohort study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. We identified patients who were assigned UC-related disease codes and newly prescribed 5-ASA between April 2015 and September 2019 and specified the number of days until 5-ASA prescriptions were interrupted during a follow-up of up to 365 days. Among the 137 million patients who were covered by the universal health insurance in Japan during the study period, 68,234 eligible patients were identified. The 5-ASA persistence in these patients were 87.2%, 65.6%, and 56.4% after 30, 180, and 365 days, respectively. The 5-ASA persistence by subtype at 365 days was 54.4%, 56.4%, and 57.6% for time-dependent, pH-dependent, and multi-matrix system types, respectively. The 5-ASA persistence rate after 365 days was 65.0% for those under 20 years of age, 51.0% for those 20\u201339 years old, 57.5% for those 40\u201364 years old, and 65.5% for those over 64 years of age. This study revealed the 1-year persistence of newly prescribed 5-ASA in patients with UC newly prescribed 5-ASA in Japan, based on a national claims database of more than 100 million individuals.<\/jats:p>","DOI":"10.1371\/journal.pone.0316181","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T18:33:16Z","timestamp":1735583596000},"page":"e0316181","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Persistence of newly prescribed 5-aminosalicylic acid in patients with ulcerative colitis: A nationwide comprehensive database study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3652-7547","authenticated-orcid":true,"given":"Tatsuya","family":"Noda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6124-3856","authenticated-orcid":true,"given":"Kotaro","family":"Kuwaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munehito","family":"Machida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Okumura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Nishioka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-6157","authenticated-orcid":true,"given":"Tomoya","family":"Myojin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"pone.0316181.ref001","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1016\/S0140-6736(07)60750-8","article-title":"Inflammatory 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UOEH"},{"key":"pone.0316181.ref040","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1007\/s00228-012-1293-7","article-title":"Long-term use of antiplatelet drugs by stroke patients: a follow-up study based on prescription register data","volume":"68","author":"K \u00d8stergaard","year":"2012","journal-title":"Eur J Clin Pharmacol"},{"key":"pone.0316181.ref041","first-page":"319","article-title":"Mortality tracking using the national database of health insurance claims and specific health checkups of Japan (NDB)","volume":"40","author":"S Kubo","year":"2020","journal-title":"Jpn J Inform"},{"key":"pone.0316181.ref042","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12876-017-0604-y","article-title":"Real life results in using 5-ASA for maintaining mild to moderate UC patients in Japan, a multi-center study, OPTIMUM Study","volume":"17","author":"M Nagahori","year":"2017","journal-title":"BMC Gastroenterol"},{"key":"pone.0316181.ref043","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1111\/j.1365-2036.2008.03698.x","article-title":"Review article: medication non-adherence in ulcerative colitis\u2014strategies to improve adherence with mesalazine and other maintenance therapies","volume":"27","author":"AB Hawthorne","year":"2008","journal-title":"Aliment Pharmacol Ther"},{"key":"pone.0316181.ref044","doi-asserted-by":"crossref","first-page":"e000853","DOI":"10.1136\/bmjgast-2021-000853","article-title":"Modelling the benefits of an optimised treatment strategy for 5-ASA in mild-to-moderate ulcerative colitis","volume":"9","author":"E Louis","year":"2022","journal-title":"BMJ Open Gastroenterol"},{"key":"pone.0316181.ref045","unstructured":"Ministry of Health, Labour and Welfare [Internet]. Press release. Survey of public assistance recipients (Approximate figures for January 2021); c2021. [cited 2023 Mar 20]. Available from: https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/hihogosya\/m2021\/dl\/01-01.pdf."},{"key":"pone.0316181.ref046","unstructured":"Japan Medical Association Research Institute [Internet]. The comparison of medical service-related data, OECD Health Statistics 2019 (in Japanese). [cited 2023 Mar 02]. Available from: https:\/\/www.jmari.med.or.jp\/download\/RE077.pdf."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T18:33:34Z","timestamp":1735583614000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316181"}},"subtitle":[],"editor":[{"given":"Barry","family":"Kweh","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":46,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0316181","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,30]]}}}