It is widely known that exposure to residential greenness is beneficial for health. However, few studies have analyzed the association between greenery and Parkinson’s disease (PD). We selected 313,355 participants who matched the inclusion criteria from the National Health Insurance Service-National Sample Cohort, followed up from 2007 to 2015. Residential greenness, represented by the normalized difference vegetation index (NDVI), was obtained from satellite measurements. We estimated hazard ratios of PD associated with a 0.1-unit increase in long-term greenness exposure at the district level for the previous 1 year of each year until a censoring/event occurred, using time-varying Cox proportional hazard models, adjusted for individual- and area-level characteristics. During the 2,745,389 person-years of follow-up, 2621(0.8%) participants developed PD. Exposure to higher levels of residential greenness was found to be associated with a decreased risk of PD incidence (21% per 0.1-unit increase, 95% confidence interval (CI): 0.74–0.84). In subgroup analyses, stronger protective effects were observed in participants aged over 50 years, females, overweight/obese participants, non-urban residents, non-smokers, alcoholics, and those with comorbidities. Long-term exposure to greenness was beneficial to incident PD, and our findings could aid in the development of public-health strategies.

Background This study aimed to determine the association between immune checkpoint inhibitors (ICIs) and the risk of herpes zoster (HZ) incidence in patients with lung cancer. Method We obtained national claims data of 51,021 patients from South Korea with lung cancer between August 2017 and December 2021. The study population was classified into ICIs and non-ICIs groups based on prescription of ICIs at least once during the study period. To estimate the effects of ICIs treatment compared with those without ICIs treatment on HZ incidence, we used the Cox proportional hazards model adjusted for sex, age, comorbidities, and concomitant use of immunosuppressive drugs. Stratified analyses based on sex, age, and comorbidities were conducted to identify corresponding risk factors. Results Of the 51,021 study participants, 897 (1.8%) were prescribed ICIs, and 2,262 (4.4%) were diagnosed with HZ. Approximately 75.6% of the patients were male, and the prevalence of diabetes, cardiovascular disease, and chronic lung disease in the ICIs group was significantly lower than that in the non-ICIs group. The Kaplan–Meier plot showed that the probability of incidence of HZ in the ICIs group was lower than that in the non-ICIs group. Additionally, treatment with ICIs was associated with a 31% lower risk of developing HZ when compared to that seen without ICIs treatment (95% confidence interval [CI], 0.48–1.00). This association was stronger in females (hazard ratio [HR], 0.42; 95% CI, 0.19–0.94) and those less than 68 years of age (HR, 0.58; 95% CI, 0.34–0.99). Conclusion In these real-world data from an Asian population with lung cancer, ICIs treatment might be associated with a reduced risk of HZ compared to that without ICIs treatment.

Background: This study aimed to determine the association between immune checkpoint inhibitors (ICIs) and the risk of herpes zoster (HZ) incidence in patients with lung cancer. Method: We obtained national claims data of 51,021 patients from South Korea with lung cancer between August 2017 and December 2021. The study population was classified into ICI and non-ICI groups based on the prescription of ICIs at least once during the study period. To estimate the effects of ICIs treatment compared with those without ICIs treatment on HZ incidence, we used the Cox proportional hazards model adjusted for sex, age, comorbidities, and concomitant use of immunosuppressive drugs. Stratified analyses based on sex, age, and comorbidities were conducted to identify corresponding risk factors. Results: Of the 51,021 study participants, 897 (1.8%) were prescribed ICIs and 2262 (4.4%) were diagnosed with HZ. Approximately 75.6% of the patients receiving ICIs were male, and the prevalence of diabetes, cardiovascular disease, and chronic lung disease in the ICI group was significantly lower than that in the non-ICIs group. The Kaplan–Meier plot showed that the probability of incidence of HZ in the ICIs group was lower than that in the non-ICIs group. Additionally, treatment with ICIs was associated with a 31% lower incidence of developing HZ when compared to that seen without ICIs treatment (95% confidence interval [CI], 0.48–1.00). This association was stronger in females (hazard ratio [HR], 0.42; 95% CI, 0.19–0.94) and those less than 68 years of age (HR, 0.58; 95% CI, 0.34–0.99). Conclusions: In these real-world data from an Asian population with lung cancer, ICIs treatment might be associated with a reduced risk of HZ compared to that without ICIs treatment.

Background and Objectives: Spontaneous reporting (SR) of adverse drug events (ADEs) is a cornerstone of pharmacovigilance and a critical mechanism for safeguarding patient safety. However, underreporting remains a persistent global challenge. In Korea, despite the widespread use of herbal medicines (HMs), adverse event reports from traditional Korean medicine doctors (KMDs) are remarkably scarce. This study aimed to assess the knowledge, attitudes, and experiences of KMDs regarding SR, identify key barriers, and suggest strategies to strengthen the safety culture within traditional Korean medicine. Materials and Methods: A cross-sectional, anonymous online survey was distributed to licensed KMDs registered with the Association of Korean Medicine. The questionnaire covered sociodemographic characteristics and assessed respondents’ knowledge, attitudes, and experiences related to ADE reporting. Descriptive statistics and multivariate logistic regression were used to analyze associations between variables. Results: Of the 1,021 KMDs who completed the survey, the vast majority acknowledged the importance of SR and recognized their responsibility in pharmacovigilance. Nevertheless, only 5% had ever submitted an ADE report. A widespread lack of awareness about the national spontaneous reporting system (SRS), particularly its inclusion of licensed HMs, was evident. Although many respondents expressed support for expanding the scope of SR to cover all HMs, significant gaps in pharmacovigilance knowledge and limited access to relevant training were major barriers. KMDs affiliated with academic institutions or specialist groups showed higher levels of awareness, education, and reporting behavior. Conclusions: While KMDs exhibit positive attitudes toward patient safety and the role of SR, participation remains low due to knowledge deficits and inadequate training. Addressing these gaps through targeted education and expanding the national SRS to comprehensively include herbal medicines are essential steps toward enhancing pharmacovigilance and cultivating a proactive safety culture in Korean medicine.

Background and Objectives: The spontaneous reporting (SR) of adverse drug events (ADEs) is a cornerstone of pharmacovigilance and a critical mechanism for safeguarding patient safety. However, underreporting remains a persistent global challenge. In Korea, despite the widespread use of herbal medicines (HMs), adverse event reports from traditional Korean medicine doctors (KMDs) are remarkably scarce. This study aimed to assess the knowledge, attitudes, and experiences of KMDs regarding SR, identify key barriers, and suggest strategies to strengthen the safety culture within traditional Korean medicine. Materials and Methods: A cross-sectional, anonymous online survey was distributed to licensed KMDs registered with the Association of Korean Medicine. The questionnaire collected information on respondents’ sociodemographic characteristics and assessed their knowledge, attitudes, and experiences related to ADE reporting. Descriptive statistics and multivariate logistic regression were used to analyze the associations between the variables. Results: Of the 1021 KMDs who completed the survey, the vast majority acknowledged the importance of SR and recognized their role in pharmacovigilance. Nevertheless, only 5% had ever submitted an ADE report. A widespread lack of awareness about the national spontaneous reporting system (SRS), particularly its inclusion of licensed HMs, was evident. Although many respondents expressed support for expanding the scope of SR to cover all HMs, significant gaps in pharmacovigilance knowledge and limited access to relevant training were major barriers. KMDs affiliated with academic institutions or specialist groups showed higher levels of awareness, education, and reporting behavior. Conclusions: While KMDs exhibit positive attitudes toward patient safety and understand the importance of SR, their participation in it remains low due to knowledge deficits and insufficient training. Addressing these gaps through targeted education and expanding the national SRS to comprehensively include herbal medicines are essential steps toward enhancing pharmacovigilance and cultivating a proactive safety culture in Korean medicine.