Decline incidence in upper gastrointestinal bleeding in several recent years: data of the Japan claims database of 13 million accumulated patients

• Published in: Journal of Clinical Biochemistry and Nutrition Vol. 68; no. 1; pp. 95 - 100
• Main Authors: Fujimoto, Shun, Tsuruoka, Nanae, Esaki, Motohiro, Takamori, Ayako, Sakata, Yasuhisa, Shimoda, Ryo, Akutagawa, Takashi, Node, Koichi, Anzai, Keizo, Sugisaki, Nobuyuki, Iwakiri, Ryuichi, Takagi, Kuniaki, Yamanouchi, Kohei, Fujimoto, Kazuma
• Format: Journal Article
• Language: English
• Published: Japan SOCIETY FOR FREE RADICAL RESEARCH JAPAN 01.01.2021; Japan Science and Technology Agency; the Society for Free Radical Research Japan
• Subjects: antithrombotic; Bleeding; Data centers; Evaluation; Gastroesophageal reflux; gastroesophageal reflux disease; JMDC; Original; peptic ulcer; Peptic ulcers; proton pump inhibitor; Proton pump inhibitors; Time dependence; Ulcers; Japan; JMDC; peptic ulcer; gastroesophageal reflux disease; proton pump inhibitor; antithrombotic
• ISSN: 0912-0009; 1880-5086
• DOI: 10.3164/jcbn.20-153

This study was to examine the recent trends in upper gastrointestinal bleeding in Japan using a large-scale real-world database. The incidence of upper gastrointestinal bleeding was evaluated in the Japan Medical Data Center claims database of 13,019,713 patients aged 20 to 74 years with traceability for 3 months from 2009 to 2014. The incidence was compared with peptic ulcers and gastroesophageal reflux disease. The prescription of medications was also evaluated. The incidence of bleeding was 0.137%, 0.121%, 0.113%, 0.106%, 0.099%, and 0.105% during 2009 to 2014 with a time-dependent decline (p<0.001). Peptic ulcers (>10 times higher than the incidence of bleeding) decreased with time (p<0.001), whereas gastroesophageal reflux disease increased (p = 0.006). Upper gastrointestinal bleeding was higher in male patients and older patients (60–74 years old) (p<0.001 respectively). The prescription rate of antithrombotic medications and proton pump inhibitors increased from 2009 to 2014 (p<0.001 respectively). The incidence of upper gastrointestinal bleeding decreased from 2009 to 2014 in this relatively large-scale real-world database in Japan, concomitant with the decrease in peptic ulcers. The decreased incidence might have been due to changes in the disease structure and therapeutic strategies over time.