Epi Database. June 2018 Newsletter

Epi Database June 2018 Newsletter

Epi Database June 2018 Newsletter Epi Database is the premier online database that provides reliable, documented and well-researched epidemiological estimates. All epidemiologies are thoroughly researched in scientific literature and are reviewed on an annual basis. Kantar Health appreciates your subscription to Epi Database and is committed to supplying you with valuable epidemiological information needed for key management decisions, including defining relevant market definitions and patient segments; evaluating market sizes and potential for new indications for in-line products or in-licensing opportunities, and for prioritizing drug development efforts.

Epi Database June 2018 Newsletter Updated Indications On June 26th, estimates for 10 indications will be updated. Click on the indications below for more information. Atherosclerosis Chronic Obstructive Pulmonary Disorder NEW SEGMENTS! Hyponatremia NEW SEGMENTS! Obesity EPI DATABASE G7 Osteoporosis NEW SEGMENTS! Peripheral Arterial Hypertension NEW SEGMENTS! EPI DATABASE BRIC Acne Chronic Obstructive Pulmonary Disorder NEW SEGMENTS! Ocular Hypertension Smoking NEW SEGMENTS! 3

Acne EPI DATABASE BRIC After a thorough review of the literature, no changes were made to the acne estimates due to the following: No newer sources were available for China; the currently used source is still the most reliable Estimates for Brazil, India and Russian Federation are not being shown at this time due to a lack of reliable, country-specific data Although acne is widely considered a condition specific to adolescents, nearly 30% of acne cases in China are over the age of 25*. Acne Age Distribution 10-14 9% 25+ 29% 20-24 29% 15-19 33% *Source: Shen, et al. (2012) 4

Atherosclerosis EPI DATABASE G7 Prevalence of symptomatic atherosclerosis will increase with this update for the all countries, due to the following changes: + Increases in the rates of MI, ischemic stroke, peripheral artery and peripheral vascular disease, that were previously updated, are being reflected in the new calculations Atherosclerosis can lead to coronary artery disease (CAD) which can be directly visualized by performing a cardiac catheterization 0.15 0.14 0.13 0.12 0.11 0.1 0.09 0.08 0.07 0.06 Symptomatic Atherosclerosis Rates 2010 2015 2020 2025 Old New https://nursingcrib.com/wp-content/uploads/cardiaccatheterization.jpg 5

Chronic Obstructive Pulmonary Disorder (COPD) EPI DATABASE G7 After thorough review, some adjustments to the prevalence of COPD across countries will occur during this update, due to the following changes: Total Prevalence + Newer, population-based data is being used for the United Kingdom, which resulted in slightly higher estimates than previously reported. + Estimates are now both age- and gender-specific with the addition of the age 18-39 year population (previously epi started at age 40) which resulted in some minor changes to the total prevalence estimates shown previously. Among total prevalence studies, over 50% of those with COPD are asymptomatic (GOLD stage 1)* Diagnosed Prevalence + New sources available for prevalence of diagnosed COPD resulted in higher estimates for most markets except Germany where estimates are now slightly lower than previously reported. New patient segments now being added: + Severity among the treated *Source: Buist et al, 2007 6

Chronic Obstructive Pulmonary Disease (COPD) EPI DATABASE BRIC COPD for BRIC was updated in March 2018, but a newer, more robust publication of COPD prevalence using GOLD criteria in China has resulted in a revision to the China estimates. Estimates for GOLD prevalence in China are now higher than previously reported No changes were made to the diagnosed prevalence in China. Additionally, no changes were made to the estimates for Brazil, India, and Russia. New patient segments now being added: + Urban (GOLD Criteria), Diagnosed (GOLD criteria) prevalence in China The prevalence rate of COPD in urban China is lower than the prevalence rate of COPD in rural China. COPD Prevalence in China 7% 10% Urban Rural *Source: Wang et al, 2018 7

Hyponatremia EPI DATABASE G7 Prevalence of hyponatremia will increase with this update for all countries due to the following methodological changes: + Newer, country-specific hospitalized patient data is being used for all countries + A more recent US source based on serum sodium measurements obtained from laboratory test results instead of ICD-9 codes is being applied to all countries Overall prevalence of hyponatremia is higher in Europe than in US and Japan + Gender breakouts are now available for the European countries Overall rate New patient segments now being added: + Severity of hyponatremia based upon new joint European guidelines by ESICM, ESE and ERA-EDTA 2.00% 1.50% 1.00% 1.08% 1.50% 1.73% 0.50% 0.00% US Japan EU 8

Obesity EPI DATABASE G7 Prevalence of obesity will increase with this update for the all countries due to the following changes: + Newer, population-based data is being used for all countries + Estimates of obesity have increased for all countries, but the rates are beginning to plateau for most countries except the United States Worldwide obesity has nearly doubled since 1980* 41% 40% 39% 38% 37% 36% 35% 34% 33% 32% 31% 30% Adult Obesity in the US 2007 2009 2011 2013 2015 Obesity Rates *http://easo.org/education-portal/obesity-facts-figures/ 9

Ocular Hypertension EPI DATABASE BRIC Ocular Hypertension prevalence in Brazil is now lower due to the following methodology changes: Updated estimates are now based upon a country-specific data source in Brazil. The previous analysis extrapolated Hispanic-specific rates from the United States. Estimates in China, India and Russia remain the same as no newer sources were available. Prevalence of ocular hypertension in China is not influenced by whether subjects reside in urban or rural areas. *Source: Xu et al, 2009 10

Osteoporosis and Low Bone Mass (Osteopenia) EPI DATABASE G7 + The update in the US will result in lower prevalence of osteoporosis given the latest NHANES data while low bone mass prevalence will remain comparable to previous estimates + A newer EU source (France, Germany, UK sample) will result in a decrease in osteoporosis prevalence and an increase in low bone mass prevalence + In Japan, osteoporosis prevalence is based upon newer data. This resulted in a decrease in prevalence for osteoporosis FN defined as BMD 70% YAM. However, it resulted in an increase in prevalence for osteoporosis FN defined as BMD -2.5 SD and osteopenia FN (defined as BMD -1 to -2.5 SD) NEW patient segments now being added: + Osteoporosis prevalence using National Bone Health Alliance Criteria (US only) + Prevalence at FN or LS (US, EU, Japan) + Treatment and Severity (US, EU, Japan) 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Osteoporosis and low bone mass prevalence are comparable in the US and EU. In Japan, prevalence is higher for osteoporosis and lower for low bone mass Osteoporosis Low bone mass 11

Pulmonary Arterial Hypertension (PAH) EPI DATABASE G7 New sources utilized in this analysis have resulted in lower incidence and higher prevalence for the US and Europe In Japan, diagnosed prevalence is being updated using the MHLW Intractable Disease data. In the previous epi, rates from Europe had been extrapolated. The update will result in slightly higher prevalence estimates than previously shown Typically PAH patients have delayed diagnosis, where almost 80% of the incident population has WHO functional class III or IV. NEW patient segments added: + Etiology segmentation (IPAH/ HPAH, APAH) + Treatment + WHO Functional Class I, II, III, IV (US and EU) WHO FC of Incident PAH patients FC I FC II FC III FC IV Source: Radegran et. al. 2016 (Sweden) 12

Smoking EPI DATABASE BRIC Prevalence estimates of smoking in China, India, and Russia are lower than previously reported; whereas Brazil is now higher. These changes are due to the following methodology changes: Newer population-based country-specific sources are now available in all countries. Age-specific estimates were added for Brazil and China. Around 50% of males in both China and Russia are current smokers. New patient segments now being added: + Urban (China) + Urban (India) *Source: Epi Database 13

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