Treatment patterns among patients with moderate-to-severe ulcerative colitis in the United States and Europe

English version

Autoři: Alessandro Armuzzi ^aff001; Marco daCosta DiBonaventura ^aff002; Miriam Tarallo ^aff003; James Lucas ^aff004; Daniel Bluff ^aff004; Benjamin Hoskin ^aff004; Danielle Bargo ^aff002; Joseph C. Cappelleri ^aff005; Daniel Quirk ^aff006; Leonardo Salese ^aff006
Působiště autorů: IBD Unit, Presidio Columbus Fondazione Policlinico A. Gemelli IRCCS–Università Cattolica del Sacro Cuore, Rome, Italy ^aff001; Patient Health Impact, Pfizer Inc, New York, NY, United States of America ^aff002; Patient Health Impact, Pfizer Inc, Rome, Italy ^aff003; Adelphi Real World, Macclesfield, SK, United Kingdom ^aff004; Biostatistics, Pfizer Inc, Groton, CT, United States of America ^aff005; Medical Affairs, Pfizer Inc, Collegeville, PA, United States of America ^aff006
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227914

Souhrn

Objective

The aim of the present study is to examine how moderate-to-severe ulcerative colitis (UC) is currently managed in real-world clinical practice across the United States (US) and European Union Five (EU5; France, Germany, Italy, Spain, and the United Kingdom).

Methods

Data from the 2017 Adelphi Inflammatory Bowel-Disease Specific Programme (IBD-DSP) were used. The IBD-DSP is a database of patient chart information abstracted by selected gastroenterologists across the US and EU5. Eligible gastroenterologists who agreed to participate were asked to complete patient record forms for the next seven consecutive eligible adult patients with UC. Only charts from patients with moderate-to-severe UC were included in the analysis (defined as those with documented administration of either an immunosuppressant [IM] or a biologic). Treatment patterns were reported descriptively.

Results

411 and 1191 patient charts were included in the US and EU5 (mean ages 44.2 and 39.6 years; 53.0% and 43.5% female), respectively. For those with complete treatment history, 40.7% and 52.9% used either an IM or biologic as their first treatment (with or without steroids). Usage of these therapies increased in subsequent lines. The percentage of patients treated with combination therapy (i.e., biologic therapy with a concomitant IM) in first line generally varied between 10–20% (e.g., US: adalimumab (ADA), 10.8%; infliximab (IFX), 18.2%; EU5: ADA, 12.5%; IFX, 19.9%), though increased in later lines in the EU5. Among patients currently using a biologic therapy, between 10–40% of patients used a higher than indicated dose or greater than indicated dosing frequency during maintenance (e.g., US: IFX, 37.1%; ADA, 13.4%; EU5: IFX, 39.1%; ADA, 36.1%). In both the US and EU5, the primary reason for switching therapy was efficacy-related.

Conclusions

In this analysis, many patients with moderate-to-severe UC use an IM or biologic as their first therapy after diagnosis. Combination therapy and dose escalation are also common, and underscore the challenges with managing this patient population.

Klíčová slova:

Europe – European Union – Finance – Charts – Physicians – Steroid therapy – Ulcerative colitis – United States

Zdroje

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Treatment patterns among patients with moderate-to-severe ulcerative colitis in the United States and Europe

Souhrn

Objective

Methods

Results

Conclusions

Klíčová slova:

Zdroje

PLOS One

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