Prescription trends in children with pervasive developmental disorders: a claims data-based study in Japan.
BACKGROUND
The only drug approved for pervasive developmental disorders (PDD) in Japan is pimozide. Several psychotropic drugs are also prescribed for offlabel use in Japan, but details regarding their prescription and use are largely unknown. The purpose of this study was to clarify the use of drug treatment in Japanese children with PDD.


METHODS
Data were extracted from claims data from the Japan Medical Data Center for children younger than 18 years of age who were newly diagnosed with PDD (International Classification of Diseases version 10 codes: F84) from 2005 to 2010 (total of 3276 patients as of 2010). The prescription rates were presented as the percentage of PDD patients who were prescribed each drug.


RESULTS
Prior to 2010, the prescription rates for atypical antipsychotics, other antipsychotics, psychostimulants, all other central nervous system drugs, anticovnvulsants, non-barbiturates, and Parkinson's disease/syndrome drugs significantly increased among the Anatomical Therapeutic Chemical classifications defined as the "nervous system" (trend P≤0.02). The prescription rate for risperidone consistently increased, reaching 6.9% in 2010 (trend P<0.0001), the highest rate of the surveyed drugs among the antipsychotics. The prescription rate for aripiprazole also increased (trend P<0.0001), reaching 1.9% in 2010. The prescription rate for pimozide showed no annual changes, with a low rate of 0.4% in 2010.


CONCLUSIONS
Compared with pimozide, the prescription rates for risperidone, aripiprazole and other psychotropic drugs have increased. Because safety data for these drugs in Japanese children are sparse, there is a need for future safety evaluations of these drugs in Japanese children.
Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, 980-8575, Japan.
Michihiro
M
Satoh
Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, 980-8575, Japan. dontaku@mail.tains.tohoku.ac.jp.|Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Japan. dontaku@mail.tains.tohoku.ac.jp.|Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan. dontaku@mail.tains.tohoku.ac.jp.
Taku
T
Obara
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hidekazu
H
Nishigori
School of Pharmacy, Nihon University, Chiba, Japan.
Nobuhiro
N
Ooba
Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Yoshihiko
Y
Morikawa
Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Japan.|Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Mami
M
Ishikuro
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.|Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Hirohito
H
Metoki
Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Japan.|Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Masahiro
M
Kikuya
Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, 980-8575, Japan.
Nariyasu
N
Mano
D000293:Adolescent; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001321:Autistic Disorder / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000188:drug therapy*; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D061214:Patient Safety; D010868:Pimozide / Q000627:therapeutic use*; D012189:Retrospective Studies; D018570:Risk Assessment
D014150:Antipsychotic Agents; D010868:Pimozide
autism; children; pervasive developmental disorders; prescription