1.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
Objectives:
This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).
Methods:
This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.
Results:
The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.
Conclusions
This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia.
2.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
Objectives:
This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).
Methods:
This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.
Results:
The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.
Conclusions
This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia.
3.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
Objectives:
This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).
Methods:
This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.
Results:
The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.
Conclusions
This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia.
4.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
Objectives:
This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).
Methods:
This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.
Results:
The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.
Conclusions
This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia.
5.Sex Differences in Chronic Cough Epidemiology: The Korean Cough Study Group
Jiyeon KANG ; Woo Jung SEO ; Jieun KANG ; Jung Gon KIM ; Sung Jun CHUNG ; Hyung Koo KANG ; Sung-Soon LEE ; Tai Joon AN ; Hyonsoo JOO ; Hyun LEE ; Youlim KIM ; Ina JEONG ; Jinkyeong PARK ; Sung-Kyoung KIM ; Jong-Wook SHIN ; Chin Kook RHEE ; Yee Hyung KIM ; Kyung Hoon MIN ; Ji-Yong MOON ; Deog Kyeom KIM ; Seung Hun JANG ; Kwang Ha YOO ; Jin Woo KIM ; Hyoung Kyu YOON ; Hyeon-Kyoung KOO
Journal of Korean Medical Science 2024;39(38):e273-
Background:
Chronic cough is a common symptom encountered by healthcare practitioners.The global prevalence of chronic cough is 9.6%, with a female predominance. The aim of our study is to reveal the sex differences in prevalence and severity of chronic cough in South Korea, stratified by age and etiology.
Methods:
This study included adult patients with chronic cough who were recruited from 19 respiratory centers in South Korea. Patients completed the cough numeric rating scale (NRS) and COugh Assessment Test (COAT) questionnaire to assess the severity and multidimensional impact of cough.
Results:
Among the 625 patients, 419 (67.0%) were females, with a male-to-female ratio of 1:2.03. The mean age was 49.4 years, and the median duration of cough was 12 weeks. The mean NRS and COAT scores were 5.5 ± 1.8 and 9.5 ± 3.6, respectively. Female patients were older (45.3 ± 15.4 vs. 51.6 ± 15.2, P < 0.001) and more likely to have asthma/cough variant asthma (CVA) (26.7% vs. 40.8%, P = 0.001) than male patients. There was no difference in the duration or severity of cough between sexes, regardless of the cause. The male-tofemale ratio was lower for upper airway cough syndrome (UACS), asthma/CVA, and gastroesophageal reflux disease (GERD), but not for eosinophilic bronchitis (EB) or unexplained cough. The mean age of female patients was higher in UACS and asthma/CVA, but not in EB, GERD, or unexplained cough. The majority (24.2%) fell within the age category of 50s. The proportion of females with cough increased with age, with a significant rise in the 50s, 60s, and 70–89 age groups. The severity of cough decreased in the 50s, 60s, and 70–89 age groups, with no significant sex differences within the same age group.
Conclusion
The sex disparities in prevalence and severity of cough varied significantly depending on the age category and etiology. Understanding the specific sex-based difference could enhance comprehension of cough-related pathophysiology and treatment strategies.
6.Medial Arterial Calcification and the Risk of Amputation of Diabetic Foot Ulcer in Patients With Diabetic Kidney Disease
Joon Myeong SO ; Ji Ho PARK ; Jin Gyeong KIM ; Il Rae PARK ; Eun Yeong HA ; Seung Min CHUNG ; Jun Sung MOON ; Chul Hyun PARK ; Woo-Sung YUN ; Tae-Gon KIM ; Woong KIM ; Ji Sung YOON ; Kyu Chang WON ; Hyoung Woo LEE
Journal of Korean Medical Science 2023;38(21):e160-
We assessed the risk factors for major amputation of diabetic foot ulcers (DFUs) in patients with diabetic kidney disease (DKD) stages 3b–5. For DFU assessment, in addition to DFU location and presence of infection, ischemia, and neuropathy, vascular calcification was assessed using the medial arterial calcification (MAC) score. Of 210 patients, 26 (12.4%) underwent major amputations. Only the location and extension of DFU, represented by Texas grade differed between the minor and major amputation groups. However, after adjusting for covariates, ulcer location of mid- or hindfoot (vs. forefoot, odds ratio [OR] = 3.27), Texas grades 2 or 3 (vs. grade 0, OR = 5.78), and severe MAC (vs. no MAC, OR = 4.46) was an independent risk factor for major amputation (all P < 0.05). The current use of antiplatelets was a possible protective factor for major amputations (OR = 0.37, P = 0.055). In conclusion, DFU with severe MAC is associated with major amputation in patients with DKD.
7.Real-World Experience of the Efficacy and Safety of Upadacitinib 15 mg in Patients with Atopic Dermatitis in Korea
Hyoung Min NA ; Eun Ji CHOI ; Soo Hyun JEON ; Zhong Fan CHANG ; Myoung Eun CHOI ; Ik Jun MOON ; Joon Min JUNG ; Woo Jin LEE ; Sung Eun CHANG ; Mi Woo LEE ; Chong Hyun WON
Korean Journal of Dermatology 2023;61(2):86-91
Background:
Upadacitinib is an oral Janus kinase1 (JAK1)-selective inhibitor, which showed a quick and significant effect on patients with atopic dermatitis in several phase 3 clinical studies. Although, an increasing number of studies have reported data on the real-world efficacy and safety of upadacitinib for the treatment of atopic dermatitis, no studies have yet been published in Korea.
Objective:
We assessed the real-world efficacy and safety of upadacitinib for the treatment of atopic dermatitis in Korean patients.
Methods:
A total of 17 patients with atopic dermatitis who received 15 mg of oral upadacitinib everyday for 16 weeks, were included in this retrospective single-center study. Based on electronic medical records, the clinical characteristics, Eczema Area and Severity Index (EASI) score, and adverse events were investigated.
Results:
The mean EASI score was significantly reduced at 4 weeks of upadacitinib treatment (8.81±9.00) and gradually reduced at week 8 (5.70±7.38), week 12 (4.55±6.23), and week 16 (4.58±6.74) (p<0.001). At week 16, 61.54%, 30.77%, and 15.38% of patients achieved EASI 75, EASI 90, and EASI 100 responses, respectively. There was no statistically significant difference between EASI 75 and EASI 90 by age or gender at week 16 (p>0.05). A total of 13 people (76.5%) had adverse events, of which acne was the most common. In all patients, the symptoms were mild and self-limited, and no patient discontinued treatment.
Conclusion
Upadacitinib was effective and safe for Korean patients with atopic dermatitis in real-world clinical practice.
8.Standardized Database of 12-Lead Electrocardiograms with a Common Standard for the Promotion of Cardiovascular Research: KURIAS-ECG
Hakje YOO ; Yunjin YUM ; Soo Wan PARK ; Jeong Moon LEE ; Moonjoung JANG ; Yoojoong KIM ; Jong-Ho KIM ; Hyun-Joon PARK ; Kap Su HAN ; Jae Hyoung PARK ; Hyung Joon JOO
Healthcare Informatics Research 2023;29(2):132-144
Objectives:
Electrocardiography (ECG)-based diagnosis by experts cannot maintain uniform quality because individual differences may occur. Previous public databases can be used for clinical studies, but there is no common standard that would allow databases to be combined. For this reason, it is difficult to conduct research that derives results by combining databases. Recent commercial ECG machines offer diagnoses similar to those of a physician. Therefore, the purpose of this study was to construct a standardized ECG database using computerized diagnoses.
Methods:
The constructed database was standardized using Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) and Observational Medical Outcomes Partnership–common data model (OMOP-CDM), and data were then categorized into 10 groups based on the Minnesota classification. In addition, to extract high-quality waveforms, poor-quality ECGs were removed, and database bias was minimized by extracting at least 2,000 cases for each group. To check database quality, the difference in baseline displacement according to whether poor ECGs were removed was analyzed, and the usefulness of the database was verified with seven classification models using waveforms.
Results:
The standardized KURIAS-ECG database consists of high-quality ECGs from 13,862 patients, with about 20,000 data points, making it possible to obtain more than 2,000 for each Minnesota classification. An artificial intelligence classification model using the data extracted through SNOMED-CT showed an average accuracy of 88.03%.
Conclusions
The KURIAS-ECG database contains standardized ECG data extracted from various machines. The proposed protocol should promote cardiovascular disease research using big data and artificial intelligence.
9.Consensus Document on Perioperative Antithrombotic Management: Part 2. Case Study
Yongwhi PARK ; Ae-Young HER ; Hyun Kuk KIM ; Jae Youn MOON ; Jae Hyoung PARK ; Keun-Ho PARK ; Kyung Hoon LEE ; Hyung Joon JOO ; Ho Yeon WON ; Sung Gyun AHN ; Hong Jun PARK ; Sung-Jin HONG ; Beom Joon KIM ; Seung Pil BAN ; Jung-Won SUH ; Young Bin SONG ; Jung Rae CHO ; Young-Hoon JEONG ; Weon KIM ; Eun-Seok SHIN ;
Korean Journal of Medicine 2022;97(4):204-228
Given the progressive improvements in antithrombotic strategies, management of cardiovascular disease has become sophisticated/refined. However, the optimal perioperative management of antithrombotic therapy in patients with acute coronary syndrome or who are scheduled for percutaneous coronary intervention remains unclear. Assessments of the thrombotic and hemorrhagic risks are essential to reduce the rates of mortality and major cardiac events. However, the existing guidelines do not mention these topics. This case-based consensus document deals with common clinical scenarios and offers evidence-based guidelines for individualized perioperative management of antithrombotic therapy in the real world.
10.Consensus Document on Perioperative Antithrombotic Management: Part 1. A Review
Yongwhi PARK ; Ae-Young HER ; Hyun Kuk KIM ; Jae Youn MOON ; Jae Hyoung PARK ; Keun-Ho PARK ; Kyung Hoon LEE ; Hyung Joon JOO ; Ho Yeon WON ; Sung Gyun AHN ; Hong Jun PARK ; Sung-Jin HONG ; Beom Joon KIM ; Seung Pil BAN ; Jung-Won SUH ; Young Bin SONG ; Jung Rae CHO ; Young-Hoon JEONG ; Weon KIM ; Eun-Seok SHIN ;
Korean Journal of Medicine 2022;97(3):150-163
The prevalence of ischemic heart disease is steadily growing as populations age. Antithrombotic treatment is a key therapeutic modality for the prevention of secondary cerebro-cardiovascular disease. Patients with acute coronary syndrome or who are undergoing percutaneous coronary intervention must be treated with dual antiplatelet therapy for a mandatory period. The optimal perioperative antithrombotic regimen remains debatable; antithrombotics can cause bleeding. Inadequate antithrombotic regimens are associated with perioperative ischemic events, but continuation of therapy may increase the risks of perioperative hemorrhagic complications (including mortality). Many guidelines on the perioperative management of antithrombotic agents have been established by academic societies. However, the existing guidelines do not cover all specialties, nor do they describe the thrombotic and hemorrhagic risks associated with various surgical interventions. Moreover, few practical recommendations on the modification of antithrombotic regimens in patients who require non-deferrable interventions/surgeries or procedures associated with a high risk of hemorrhage have appeared. Therefore, cardiologists, specialists performing invasive procedures, surgeons, dentists, and anesthesiologists have not come to a consensus on optimal perioperative antithrombotic regimens. The Korean Platelet-Thrombosis Research Group presented a positioning paper on perioperative antithrombotic management. We here discuss commonly encountered clinical scenarios and engage in evidence-based discussion to assist individualized, perioperative antithrombotic management in clinical practice.

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