The study, “Demographics, treatment trends, and survival rate in incident pulmonary artery hypertension in Korea: A nationwide study based on the health insurance review and assessment service database,” was published in the journal PLOS One.
PAH is a chronic condition caused by the narrowing of arteries, resulting in a drastic decrease in blood pressure in the lungs. Several epidemiological studies have been conducted to understand the prevalence, clinical prognosis, and treatment of PAH. However, data pertaining to the Asian population is limited.
To address this lack of data, a team led by researchers from Yonsei University College of Medicine in Seoul, South Korea, reassessed medical claims to understand the PAH pattern and treatment profile in the Korean patient population.
Researchers used the Korean Health Insurance Review and Assessment Service (HIRA) database for the study. The HIRA database holds all the medical billing information of the South Korean population. Patient information, such as medical history, diagnoses, and treatment cost, is available through HIRA.
The team identified 1,307 patients (mean age of 44 years) who were newly diagnosed with PAH between 2008 and 2016. The mean follow-up period was 1.9 years.
Results showed that PAH was prevalent among women in the South Korean population, making up 69.3% of all the identified PAH patients.
Idiopathic PAH was the most common form of the disease in the study population, affecting 51.6% of patients. Other types included acquired PAH associated with congenital heart disease in 25.8% of patients, followed by acquired PAH associated with connective tissue disease in 17.2%.
Prescription data showed that 80.1% of the patients received specific PAH treatment, with 61.7% (807 patients) prescribed a single treatment (monotherapy), while 18.4% (240 patients) received a combination therapy.
Tracleer (bosentan, marketed by Actelion Pharmaceuticals), prescribed to 50.6% of patients, and Beraprost (sold in Japan and South Korea), prescribed to 35.2% of patients, were the two most commonly used monotherapies. They were also the ones most frequently prescribed as a combination treatment, given to 32.9% of the patients.
Of the analyzed population, 55.1% (720 patients) were hospitalized more than once, and the average stay was for nine days.
Researchers found that, at the mean follow-up of 1.9 years, 581 of the patients analyzed had died. Furthermore, the estimated survival rates decreased over time — the one-, two-, three-, and five-year estimated survival rates in this study population were 84.9%, 62.2%, 54.3%, and 46%, respectively. These results are in line with data from other countries.
The team concluded that “the prevalence and incidence of PAH in the Korean population is currently comparable with that in previous registries.”