A marked increase in antipsychotic prescriptions has been observed in most countries since the introduction of second-generation antipsychotics. Misuse could partly explain this rise. We described the use of antipsych...A marked increase in antipsychotic prescriptions has been observed in most countries since the introduction of second-generation antipsychotics. Misuse could partly explain this rise. We described the use of antipsychotic medication in France. This retrospective analysis was conducted on the sample “Echantillon généraliste de beneficiaries” from the French National Insurance Healthcare System. All reimbursements for antipsychotic medications in 2010 were identified. Antipsychotics use was described in terms of patient’s profiles and condition of use. In 2010, we identified 11,729 single patients with at least one reimbursement for antipsychotic medication (2.23% of French health insurance beneficiaries). The mean age in the population was 54 (sd 20) years. Forty-one percent had declared psychiatric disorder and 15% had a psychiatric follow-up for unknown diseases. Schizophrenia, others psychosis and personality disorders were the three main diagnoses of psychiatric disease. Patients without declared psychiatric disorders and without psychiatric follow-up accounted for 23% (aged between 15 and 65) and 20% (aged 65 years and over) of the population using antipsychotics. Forty-five percent of patients aged between 15 and 65 had more than 3 months of treatment refunded. Patients aged 65 years and over were 69% without dementia and 47% had more than three months of treatment of antipsychotics refunded during the year. These results suggested that antipsychotic treatments were used in France at long term in particular for patients without declared psychiatric disorder or psychiatric follow-up.展开更多
Background Data on biosimilar use in pediatric inflammatory bowel diseases(IBD)are scarce compared to the status of studies in adults,resulting in limitations in its treatment.We compared effectiveness and safety of b...Background Data on biosimilar use in pediatric inflammatory bowel diseases(IBD)are scarce compared to the status of studies in adults,resulting in limitations in its treatment.We compared effectiveness and safety of biosimilars versus originators in this population.Methods We used data from the French National Health Data System to identify children(less than 18 years old at treatment initiation)initiating treatment with a biosimilar or the originator infliximab or adalimumab for Crohn’s disease(CD)or ulcerative colitis(UC),from first biosimilar launch(January 2015 and October 2018,respectively)to 31 December 2022.Patients’follow-up went until 30 June 2023.We compared the risks of treatment failure and overnight hospitalization in biosimilar versus originator new users using inverse harzard ratio(HR)of probability of treatment weighted Cox regressions(IPTW).Results We included 5870 patients(infliximab:n=3491;adalimumab:n=2379)in the study.Biosimilars represented,respectively,76.0%(n=2652)and 29.0%(n=691)of infliximab and adalimumab initiations.CD represented 70.9%(n=2476)and 69.0%(n=1642)of infliximab and adalimumab initiations.Biosimilar use was not associated with increased risks of treatment failure[IPTW HR(95%confidence interval,CI):infliximab 0.92(0.78–1.09)in CD,0.98(0.76–1.27)in UC;adalimumab 0.98(0.85–1.14)in CD,1.01(0.82–1.24)in UC].Occurrence of all-cause hospitalization was not different between exposure groups[IPTW HR(95%CI):infliximab 0.96(0.78–1.18);adalimumab 1.03(0.80–1.33)].No difference in occurrence of serious infections,mainly gastro-intestinal or dermatological,was found.Conclusion We provide reassuring results on the use,effectiveness and safety of biosimilars in a large unselected pediatric population suffering from IBD.展开更多
文摘A marked increase in antipsychotic prescriptions has been observed in most countries since the introduction of second-generation antipsychotics. Misuse could partly explain this rise. We described the use of antipsychotic medication in France. This retrospective analysis was conducted on the sample “Echantillon généraliste de beneficiaries” from the French National Insurance Healthcare System. All reimbursements for antipsychotic medications in 2010 were identified. Antipsychotics use was described in terms of patient’s profiles and condition of use. In 2010, we identified 11,729 single patients with at least one reimbursement for antipsychotic medication (2.23% of French health insurance beneficiaries). The mean age in the population was 54 (sd 20) years. Forty-one percent had declared psychiatric disorder and 15% had a psychiatric follow-up for unknown diseases. Schizophrenia, others psychosis and personality disorders were the three main diagnoses of psychiatric disease. Patients without declared psychiatric disorders and without psychiatric follow-up accounted for 23% (aged between 15 and 65) and 20% (aged 65 years and over) of the population using antipsychotics. Forty-five percent of patients aged between 15 and 65 had more than 3 months of treatment refunded. Patients aged 65 years and over were 69% without dementia and 47% had more than three months of treatment of antipsychotics refunded during the year. These results suggested that antipsychotic treatments were used in France at long term in particular for patients without declared psychiatric disorder or psychiatric follow-up.
文摘Background Data on biosimilar use in pediatric inflammatory bowel diseases(IBD)are scarce compared to the status of studies in adults,resulting in limitations in its treatment.We compared effectiveness and safety of biosimilars versus originators in this population.Methods We used data from the French National Health Data System to identify children(less than 18 years old at treatment initiation)initiating treatment with a biosimilar or the originator infliximab or adalimumab for Crohn’s disease(CD)or ulcerative colitis(UC),from first biosimilar launch(January 2015 and October 2018,respectively)to 31 December 2022.Patients’follow-up went until 30 June 2023.We compared the risks of treatment failure and overnight hospitalization in biosimilar versus originator new users using inverse harzard ratio(HR)of probability of treatment weighted Cox regressions(IPTW).Results We included 5870 patients(infliximab:n=3491;adalimumab:n=2379)in the study.Biosimilars represented,respectively,76.0%(n=2652)and 29.0%(n=691)of infliximab and adalimumab initiations.CD represented 70.9%(n=2476)and 69.0%(n=1642)of infliximab and adalimumab initiations.Biosimilar use was not associated with increased risks of treatment failure[IPTW HR(95%confidence interval,CI):infliximab 0.92(0.78–1.09)in CD,0.98(0.76–1.27)in UC;adalimumab 0.98(0.85–1.14)in CD,1.01(0.82–1.24)in UC].Occurrence of all-cause hospitalization was not different between exposure groups[IPTW HR(95%CI):infliximab 0.96(0.78–1.18);adalimumab 1.03(0.80–1.33)].No difference in occurrence of serious infections,mainly gastro-intestinal or dermatological,was found.Conclusion We provide reassuring results on the use,effectiveness and safety of biosimilars in a large unselected pediatric population suffering from IBD.
