Real-World Epidemiology, Clinical and Economic Burden of Chronic Hepatitis B in Japan: A Retrospective Study Using JMDC Claims Database.

INTRODUCTION: Chronic hepatitis B (CHB) is one of the world's major healthcare problems, especially in the Western Pacific regions. This study describes the prevalence, incidence, treatment profiles and clinical and economic burden of chronic hepatitis B patients in Japan using the Japan Medical Data Center (JMDC) Claims Database. METHODS: This is a retrospective observational study. Prevalence cases were identified as patients with ≥ 1 inpatient or ≥ 2 outpatient CHB diagnoses and ≥ 2 records for hepatitis B tests or ≥ 1 prescription for CHB treatment between January 2010 and December 2019. Newly diagnosed CHB patients were defined as patients diagnosed from 2010 to 2018 with no history of the disease up to 2 years prior to the diagnosis. The index date is defined as the first CHB diagnosis day. We only used patients' data with ≥ 1-year post-index date. RESULTS: We identified 13,061 CHB prevalent cases (2010-2019), yielding a crude period prevalence of 0.32%. Newly diagnosed CHB patients (n = 1973; median age 52 years) were followed for a median period of 3.1 years, during which 15% received a CHB treatment. Entecavir was the most common first treatment (66%). During this period, 3.4% of the patients developed compensated cirrhosis (CC), 1.5% decompensated cirrhosis (DC) and 3.0% hepatocellular carcinoma (HCC). Around 43.3% of CHB patients were hospitalized at least once. Hospitalizations, treatment rates, serologic testing and screening for liver diseases increased as the severity of the disease progressed. The average total healthcare cost was 870,568 JPY (7779 USD) per person per year. DC and HCC resulted in the highest management costs. CONCLUSIONS: Chronic hepatitis B represents a high clinical and economic burden for patients and caregivers, given its morbidity and associated costs.

Efficacy and Safety of Methylphenidate in Children with Epilepsy and Attention Deficit Hyperactivity Disorder / 대한간질학회지

PURPOSE: Twenty percent or more of children with epilepsy may have attention deficit hyperactivity disorder (ADHD). The treatment of ADHD with epilepsy has been an important clinical issue. The aim of this study is to investigate the efficacy and safety of methylphenidate in children with epilepsy and ADHD. METHODS: The subjects were 38 children with ADHD accompanied by epilepsy diagnosed at Department of Pediatrics and Epilepsy Center, Sanggye Paik Hospital. They were examined with IQ testing and Conners scales at baseline before using methylphenidate, and follow-up study was repeated 1 year after methylphenidate. Efficacy was determined by Conners scales and IQ score results. Safety was determined by measuring changes in seizure frequency, and electroencephalographic findings. RESULTS: According to their parents and teachers' reports, methylphenidate improved ADHD symptoms in 24 children (63.2%). Three of them (7.9%) showed significant improvement in IQ scores and 7 children (18.4%) revealed significant improvement in cognitive function with rising IQ scores between 10 and 15 points. There were no worsening in seizure frequency, and electroencephalographic findings after methylphenidate. CONCLUSION: Methylphenidate is effective and safe treatment in children with epilepsy and ADHD, showing significant benefit on children's behavior and academic improvement in many cases.

Validation of a Korean Version of the Quality of Life in Childhood Epilepsy Questionnaire(K-QOLCE) / 대한간질학회지

PURPOSE: There has been no adequate measure of health-related quality of life specifically for children with epilepsy. The aim of this study was 1) to develop a Korean version of the QOLCE, an epilepsy-specific HRQOL, 2) to confirm its reliability and validity. METHODS: The QOLCE was adapted to Korean language through a translation-backtranslation procedure. The subjects were 219 children (M:F=117:102) with epilepsy (age 4-17 years) and their guardians. They completed a questionnaire of 42-items covering five domains:physical function, emotional well-being, cognitive function, social function, and behavior. We assessed internal consistency and test-retest reliability. Construct validity was assessed by correlating scales of the K-CBCL, Korean version of Child Behavior Checklist. RESULTS: The internal consistency reliability estimated by Cronbach's a coefficient was 0.86 (ranged 0.77-0.94) for adequate reliability (p<0.05). To assess the convergent and discriminant item validities, correlations between each of the 15 subscales in the QOLCE were obtained. Each scale highly correlated with theoretically similar scales but correlation between theoretically dissimilar subscales was not high (p<0.01). For construct validity, a comparison was made between QOLCE subscales and the CBCL subscales. QOLCE subscales were significantly related to the CBCL subscales (p<0.05) CONCLUSIONS: This study demonstrated that the Korean version of the QOLCE was a reliable and valid measure at a level of comparable with the original version. These results indicate that this new instrument may be a feasible medical or surgical outcome measure for children with epilepsy.