A Real-World Analysis of Prescribing Patterns and Non-persistence of Anti-TNFα Therapy for Inflammatory Bowel Disease.

Abstract

Anti-tumor necrosis factor alpha (anti-TNFα) therapy is key to the treatment of inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn's disease (CD). The objective of this study was to investigate prescribing patterns and non-persistence of anti-TNFα therapy for the treatment of IBD in a real-world scenario. Data from the Korean National Health Insurance claims database obtained between 2010 and 2014 were evaluated to identify patients with IBD who had received anti-TNFα therapy (infliximab or adalimumab). Patient characteristics and prescribing patterns were investigated. The non-persistence rate and associated reasons were determined in patients who initiated therapy between 2010 and 2012. A total of 131,158 patients with UC and 57,286 with CD were identified. Of these 1747 UC (1.3%) and 3731 (6.5%) CD patients had received anti-TNFα therapy and were included in the analysis. Infliximab was prescribed more frequently than adalimumab (84.6% vs 15.4% in UC and 80.7% vs 19.4% in CD); 81.0% of UC and 72.0% of CD patients received anti-TNFα alone or in combination with 5-aminosalicylic acid. The non-persistence rate of anti-TNFα therapy was 72.6% and 80.4% in the UC and CD groups, respectively, with discontinuation of medication being the most common reason in both the UC and CD groups (63.9% and 73.3%, respectively). The use of anti-TNFα therapy was seen to be low, with a high rate of non-persistence. Further research efforts are required to improve the response rate and, therefore, improve persistence in patients with IBD.