| アブストラクト | INTRODUCTION: Progressive multifocal leukoencephalopathy (PML) is an infrequent yet devastating neurological infection that arises in immunocompromised patients. The epidemiological features of PML in Japan and its evolution in recent years remain unclear. There are no established treatments that directly target PML. Although mefloquine has shown in vitro activity against JC virus, its clinical effectiveness has not been confirmed in population-level studies. METHODS: We retrospectively analyzed the admission data of patients with PML recorded in the Diagnosis Procedure Combination (DPC) database from fiscal year 2010 to 2020 (11 years). Descriptive statistics were used to illustrate the epidemiological features. Changes in the frequency of PML admission, underlying diseases, and in-hospital mortality over time were also examined. Furthermore, we evaluated the effectiveness of mefloquine in improving activities of daily living at discharge using propensity score matching. RESULTS: We identified 610 PML cases diagnosed by the treating physicians, which may include possible PML. Among them, 419 were first-time admissions. The median age at admission was 62.0 years, and 62.8% were men. HIV was the most common underlying condition, accounting for 22.9% of cases, followed by hematologic malignancies (18.4%), and autoimmune diseases (17.9%). Over the study period, the frequency of PML admissions showed an increasing trend, whereas the in-hospital mortality rate showed a decreasing trend. The effectiveness of mefloquine was not confirmed. CONCLUSIONS: The results of this study will help clarify and update the clinical picture of PML in Japan. The DPC database was shown to be useful tool for epidemiological research on rare infectious disease such as PML. |
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| 組織名 | Department of Health Policy and Informatics, Graduate School of Medical and;Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku,;Tokyo 113-8510, Japan.;Tokyo 113-8510, Japan; Department of Clinical Data Management and Research,;Clinical Research Center, National Hospital Organization Headquarters, 2-5-21;Higashigaoka, Meguro-ku, Tokyo 152-8621, Japan; Department of Healthcare and;Regulatory Sciences, School of Pharmacy, Showa University, 1-5-8 Hatanodai,;Shinagawa-ku, Tokyo 142-8555, Japan.;Higashigaoka, Meguro-ku, Tokyo 152-8621, Japan. Electronic address:;kfushimi.hci@tmd.ac.jp. |
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