Top > ご連絡など > ケアマネジャーの介護保険NEWS > 【介護支援専門員 NEWS】虚血性心疾患治療の現状と将来展望――民間調査
【介護支援専門員 NEWS】虚血性心疾患治療の現状と将来展望――民間調査
2008年の厚生労働省の患者調査によれば、虚血性心疾患の患者数は81万人、うち狭心症は約60万人、急性心筋梗塞は約5万人とされる。虚血性心疾患の大部分を占める狭心症の患者数は、2010年現在およそ65万人と推計され、今後は微増もしくは横ばいと予測される。検査技術の進歩により、狭心症と診断される患者数は以前よりも増加しているが、実際に血行再建療法まで必要とする狭心症の患者数は大幅には増加しないと推測される。
虚血性心疾患治療は、近年、薬剤溶出ステントなどの新しいデバイスの進歩により、特にPCI治療(経皮的冠動脈インターベンション)において大きな変化があった。この分野の発展により、虚血性心疾患治療の選択肢が大きな広がりを見せる中、デバイスの変化は、抗血小板薬を中心とした薬物療法にも変化を及ぼしている。
また抗血小板薬市場では、大型製品として成長した「プラビックス」(製造・販売:サノフィ・アベンティス)に次ぐ新たな抗血小板薬として、海外では2009年に「エフィエント(一般名:プラスグレル)」が上市され、日本においても「エフィエント(一般名プラスグレル)」(第一三共)を始めとするADP受容体阻害薬、トロンビン受容体拮抗薬などが開発されている。
この調査では、PCI治療およびPCI実施後の抗血小板薬による薬物療法に焦点を当て、PCI症例の患者背景、ステントの選択、PCI実施後の抗血小板療法について、PCI実施医100名に対するアンケートおよび専門医4名へのヒアリングを行い、今後求められる治療についての分析を行った。
その結果、以下のように展望した。
・PCI実施症例のうちDES(薬剤溶出ステント)は約70%に使用されている。今後、ACS(急性冠症候群)でのDESの使用が推奨されれば、DESの使用率はさらに伸びる。
・虚血性心疾患の主な治療薬となる抗血小板薬の出荷額は2016年には1,600億円になると予測される。
・虚血性心疾患の治療には、抗血小板薬として、低用量アスピリン製剤がほぼ全例に使用され、PCI実施後も使用は継続される。
・PCI実施症例のうち、約90%は抗血小板薬の2剤併用療法が実施されている。2剤併用療法には、低用量アスピリン製剤と「プラビックス(一般名:硫酸クロピドグレル)」が主に使用される。
・虚血性心疾患の主な要治療薬となる抗血小板薬の出荷額は2016年には1,600億円になると予測される。
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