1.Cost-Effectiveness of Denosumab for the Treatment of Postmenopausal Osteoporosis in South Korea
Jung-Yoon KANG ; Leejung CHOI ; Ben JOHNSON ; Hyowon YANG
Journal of Bone Metabolism 2022;29(2):83-92
Background:
Osteoporosis is a progressive skeletal disease associated with an increased risk of bone fracture. This study aimed to estimate the cost-effectiveness of denosumab for osteoporotic fracture prevention compared to bisphosphonates (alendronate, ibandronate, risedronate, and zoledronate) and selective estrogen receptor modulators (raloxifene) in a cohort of postmenopausal women with osteoporosis.
Methods:
A Markov model was used to evaluate the cost and effectiveness of denosumab versus comparators. The model had a cycle length of 6 months and was run from the age of 68 years to individual patients' lifetime or the age of 100 years. The health states considered in the model were well, hip fracture, vertebral fracture, wrist fracture, other osteoporotic fracture, post-hip fracture, post-vertebral fracture, and death. Recent local data were used as inputs for the model parameters. A discount rate of 4.5% was applied to both costs and outcomes.
Results:
From the perspective of the healthcare system, denosumab was cost-effective or cost-saving compared to all comparators, considering one unit of Korea's gross domestic product per capita, USA dollar (USD) 34,870. Denosumab was cost-saving compared to ibandronate (oral) and raloxifene. Compared to alendronate, denosumab was cost-effective with an incremental cost-effectiveness ratio (ICER) of USD 767.10 per quality-adjusted life year (QALY). The ICER of denosumab vs. ibandronate IV, risedronate, and zoledronate was USD 685.63, USD 1,469.71, USD 4,668.53 per QALY, respectively.
Conclusions
The findings of this analysis suggest that denosumab is a cost-effective therapeutic option for preventing fractures in postmenopausal women with osteoporosis in South Korea.
2.Spot Urine Uric Acid to Creatinine Ratio used in the Estimation of Hyperuricosuria in the Young Korean Population
Hyowon CHOI ; Meekyung NAMGOONG
Childhood Kidney Diseases 2021;25(2):78-83
Background:
Uric acid levels in urine are measured using urine specimens 24 hours or by uric acid glomerular filtration rate (UAGFR) with spot urine, which additionally requires a blood sample. This study aimed to investigate whether urinary uric acid creatinine ratio (UUACr) obtained by spot urine alone could be recognized as a substitute for UAGFR value, and hyperuricosuria can be screened by UUACr. UUACr is known to vary with age and regional differences. This study focused on the reference value of each value in Korean young populations.Method: We enrolled Korean subjects 1–20 years with normal kidney function, from a single hospital, classified into 5 age groups, 1–5 years, 6–8 years, 9–12 years, 13–15 years, and 16–20 years. We checked spot urine uric acid, creatinine and serum uric acid, creatinine levels on the same day from February 2014 to December 2018. We measured the average of UAGFR and UUACr in each groups. The UUACr cut-off value of the upper 2 standard deviation (SD) of UAGFR were taken.
Results:
The upper 2 SD of UUACr (mg/mg) and UAGFR (mg/dL) were determined in all age groups. UUACr decreased with grown up (P=0.000), but UAGFR were not statistically different among the groups. UUACr and UAGFR were not significantly different by gender. UUACr and UAGFR were positively correlated; UUACr cut-off value of upper 2 SD UAGFR (0.54 mg/dL) was 0.65 mg/mg in total age.
Conclusions
UUACr could potentially be used to screen for hyperuricosuria.
3.Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents
Hunju LEE ; Hyowon CHOI ; Sang Baek KOH ; Hyeon Chang KIM
Epidemiology and Health 2023;45(1):e2023085-
OBJECTIVES:
We examined trends in physical activity and sedentary behavior in Korean adolescents, and their association with socioeconomic position (SEP).
METHODS:
We used data from the Korea Youth Risk Behavior Survey, a nationwide study involving students aged 12-19 conducted between 2009 and 2021. SEP was assessed based on economic status, parental education attainment, and urbanization. Physical activity was categorized into vigorous physical activity, moderate physical activity, and muscle training, and sedentary time was also measured. We conducted the log-binomial regression to calculate prevalence ratios (PRs) and prevalence differences.
RESULTS:
Our analysis included a total of 593,896 students. We observed an increasing trend in physical activity, but a worsening trend in sedentary behavior. A positive association was found between an adolescent’s physical activity and SEP indicators, except for urbanization. Adolescents with higher economic status engaged in more vigorous physical activity (high: PR, 1.26; 95% confidence interval [CI], 1.25 to 1.28; middle: PR, 1.03; 95% CI, 1.02 to 1.04). Similar associations were observed for father’s education (tertiary or above: PR, 1.11; 95% CI, 1.09 to 1.13; upper secondary: PR, 1.05; 95% CI, 1.03 to 1.07) and mother’s education (tertiary or above: PR, 1.17; 95% CI, 1.15 to 1.20; upper secondary: PR, 1.06; 95% CI, 1.04 to 1.08). Adolescents with higher economic status also showed a higher compliance rate with the guideline restricting sedentary time to 2 hours per day (high: PR, 1.28; 95% CI, 1.25 to 1.30; middle: PR, 1.03; 95% CI, 1.01 to 1.05).
CONCLUSIONS
Adolescents with higher SEP exhibited more physical activity and less sedentary time than those with lower SEP.
4.Association Between Parental BMI and Offspring’s Blood Pressure by Mediation Analysis: A Study Using Data From the Korean National Health and Nutrition Examination Survey
Hyowon CHOI ; Hunju LEE ; Yeon-Soon AHN
Journal of Preventive Medicine and Public Health 2023;56(6):533-541
Objectives:
This study analyzed the relationship between parental body mass index (BMI; BMI_p) and hypertension in their adolescent offspring (HTN_a), focusing on the mediating effect of adolescents’ BMI (BMI_a).
Methods:
Utilizing data from the Korea National Health and Nutrition Examination Survey, including participants aged 12-18, we conducted a mediation analysis while controlling for confounding factors such as age, sex, physical activity, dietary habits, household income quartile, and parents’ alcohol and smoking habits.
Results:
The study included a total of 5731 participants, of whom 3381 and 5455 participants had data on fathers’ and mothers’ BMI, respectively. For adolescent systolic blood pressure (SBP_a), the father’s BMI (BMI_f) had a significant total effect (β, 0.23; 95% confidence interval [CI], 0.12 to 0.34) and average controlled mediated effect (ACME) (β, 0.27; 95% CI, 0.23 to 0.32), but the average direct effect (ADE) was not significant. The mother’s BMI (BMI_m) had a significant total effect (β, 0.17; 95% CI, 0.09 to 0.25), ACME (β, 0.25; 95% CI, 0.22 to 0.28) and ADE (β, -0.08; 95% CI, -0.16 to 0.00). For adolescent diastolic blood pressure, both BMI_f and BMI_m had significant ACMEs (β, 0.10; 95% CI, 0.08 to 0.12 and β, 0.09; 95% CI, 0.07 to 0.12, respectively), BMI_m had a significant ADE (β, -0.09; 95% CI, -0.16 to -0.02) but BMI_f had an insignificant ADE and total effect.
Conclusions
The study found that parental BMI had a significant effect on SBP_a, mediated through BMI_a. Therefore, a high BMI in parents could be a risk factor, mediated through BMI_a, for systolic hypertension in adolescents, necessitating appropriate management.
5.Current Studies on Bakanae Disease in Rice: Host Range, Molecular Identification, and Disease Management
Yu Na AN ; Chandrasekaran MURUGESAN ; Hyowon CHOI ; Ki Deok KIM ; Se-Chul CHUN
Mycobiology 2023;51(4):195-209
The seed borne disease such as bakanae is difficult to control. Crop yield loss caused by bakanae depending on the regions and varieties grown, ranging from 3.0% to 95.4%.Bakanae is an important disease of rice worldwide and the pathogen was identified as Fusarium fujikuroi Nirenberg (teleomorph: Gibberella fujikuroi Sawada). Currently, four Fusaria (F. fujikuroi, F. proliferatum, F. verticillioides and F. andiyazi) belonging to F. fujikuroi species complex are generally known as the pathogens of bakanae. The infection occurs through both seed and soil-borne transmission. When infection occurs during the heading stage, rice seeds become contaminated. Molecular detection of pathogens of bakanae is important because identification based on morphological and biological characters could lead to incorrect species designation and time-consuming. Seed disinfection has been studied for a long time in Korea for the management of the bakanae disease of rice. As seed disinfectants have been studied to control bakanae, resistance studies to chemicals have been also conducted. Presently biological control and resistant varieties are not widely used. The detection of this pathogen is critical for seed certification and for preventing field infections. In South Korea, bakanae is designated as a regulated pathogen. To provide highly qualified rice seeds to farms, Korea Seed & Variety Service (KSVS) has been producing and distributing certified rice seeds for producing healthy rice in fields. Therefore, the objective of the study is to summarize the recent progress in molecular identification, fungicide resistance, and the management strategy of bakanae.
6.Alveolar Ridge Augmentation Using Titanium Reinforced Goretex (TRG) and Titanium Mesh in Severe Alveolar Bone Loss Area: Case Report
Wonjik KIM ; Kyungsun YOON ; Suryun HONG ; Jinkyung CHOI ; Yonguk LEE ; Dongsuk KIM ; Jongoh HYUN ; Hyowon CHO ; Jihye CHOI ; Taewoong JUNG ; Yoonki BAE ; Sunkyu KWON ; Hyunjoon CHOI ; Hyunsu LEE ; Sunam YANG
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 2011;33(1):66-72
7.Analysis of the Status and Future Direction for Digital Therapeutics in Children and Adolescent Psychiatry
Haemi CHOI ; Bora KIM ; Insoo KIM ; Jae-Gu KANG ; Yoonjae LEE ; Hyowon LEE ; Min-Hyeon PARK
Journal of the Korean Academy of Child and Adolescent Psychiatry 2023;34(4):192-203
Digital therapeutics based on software, such as artificial intelligence, virtual reality, games, and smartphone applications, are in the spotlight as new therapeutic alternatives in child and adolescent psychiatry. It draws attention to overcoming conventional therapeutics’ limitations, such as toxicity, cost, and accessibility, and encourages patients to participate in the treatment attractively. The growth potential of the digital therapeutics market for psychiatric disorders in children and adolescents in Korea and abroad has been highlighted. Clinical studies and Food and Drug Administration approvals for digital therapeutics have increased, and cases approved by the Ministry of Food and Drug Safety have emerged in Korea. As seen above, digital transformation in child and adolescent psychiatry will change treatment paradigms significantly. Therefore, as this new field has just begun to emerge, it is necessary to verify the effectiveness and scope of the application of digital therapeutics and consider preparing a compensation system and institutional arrangements. Accordingly, this study analyzed the development trends and application status of digital therapeutics in children and adolescents and presented limitations and development directions from the perspective of application in healthcare. Further, the study is expected to identify the utility and limitations of digital therapeutics for children and adolescents and establish effective application measures.
8.A novel IRAK4/PIM1 inhibitor ameliorates rheumatoid arthritis and lymphoid malignancy by blocking the TLR/MYD88-mediated NF-κB pathway.
Sae-Bom YOON ; Hyowon HONG ; Hee-Jong LIM ; Ji Hye CHOI ; Yoon Pyo CHOI ; Seong Wook SEO ; Hyuk Woo LEE ; Chong Hak CHAE ; Woo-Kyu PARK ; Hyun Young KIM ; Daeyoung JEONG ; Tran Quang DE ; Chang-Seon MYUNG ; Heeyeong CHO
Acta Pharmaceutica Sinica B 2023;13(3):1093-1109
Interleukin-1 receptor-associated kinase 4 (IRAK4) is a pivotal enzyme in the Toll-like receptor (TLR)/MYD88 dependent signaling pathway, which is highly activated in rheumatoid arthritis tissues and activated B cell-like diffuse large B-cell lymphoma (ABC-DLBCL). Inflammatory responses followed by IRAK4 activation promote B-cell proliferation and aggressiveness of lymphoma. Moreover, proviral integration site for Moloney murine leukemia virus 1 (PIM1) functions as an anti-apoptotic kinase in propagation of ABC-DLBCL with ibrutinib resistance. We developed a dual IRAK4/PIM1 inhibitor KIC-0101 that potently suppresses the NF-κB pathway and proinflammatory cytokine induction in vitro and in vivo. In rheumatoid arthritis mouse models, treatment with KIC-0101 significantly ameliorated cartilage damage and inflammation. KIC-0101 inhibited the nuclear translocation of NF-κB and activation of JAK/STAT pathway in ABC-DLBCLs. In addition, KIC-0101 exhibited an anti-tumor effect on ibrutinib-resistant cells by synergistic dual suppression of TLR/MYD88-mediated NF-κB pathway and PIM1 kinase. Our results suggest that KIC-0101 is a promising drug candidate for autoimmune diseases and ibrutinib-resistant B-cell lymphomas.