Continued persistence with mesalamine therapy in long-term persistent patients: Results from a large pharmacy database

Abstract

For patients with ulcerative colitis (UC), persistence (taking prescribed therapy over an extended period) with mesalamine therapy is recommended for successful long-term disease management. As the treatment of UC can require life-long antiinflammatory therapy, we examine the continued persistence of patients who have already remained persistent with mesalamine therapy for 12 months. Previously, we have examined the prescription refill records* of patients starting a new course of MMX mesalamine, mesalamine delayed release, mesalamine controlled release (250 or 500mg), Olsalazine, or balsalazide between March and September 2007.† ‘Continuing’ patients were defined as those who refilled their prescription within a time frame of up to double the duration of their prescription. ‘Restarting’ patients were defined as any patient who refilled their prescription after this time. In this analysis, we examine for a further 6 months the refill records for patients who were persistent (continuing) with their medication for 12 months following their first prescription. After 12 months of mesalamine therapy, 4,776 patients were identified as being persistent and were included in this analysis (MMX mesalamine, n_1,247; mesalamine delayed release, n_2,384; mesalamine controlled release 500mg, n_542; mesalamine controlled release 250mg, n-122; olsalazine, n_36; balsalazide, n_445). At 18 months, persistence rates (continuing) in these patients were 66% with MMX mesalamine, 59% with mesalamine controlled release 500mg, 59% with balsalazide, 58% with mesalamine delayed release, 49% with mesalamine controlled release 250mg and 56% with olsalazine. Patients prescribed mesalamine 1.2 g delayed-release tablets therapy received significantly more days of therapy (162 days) and collected significantly more prescriptions (five per patient) that those in the largest treatment group (mesalamine delayed-release; 96 days and three prescriptions, respectively, p<0.001). More than half of the patients who were persistent with mesalamine therapy for 12 months were still persistent at 18 months. These data suggest that the majority of patients who remain persistent for one year are likely to remain persistent. The highest rates of persistency were observed in patients receiving MMX mesalamine. The reasons for this are not fully explored, however, it is possible that low dosing frequency, low pill burden, or patient satisfaction with MMX mesalamine may help to maintain persistence with therapy. *Data owned and analyzed by SDI. †All pharmacy records were included independent of diagnosis. This research was funded by Shire Pharmaceuticals Inc., Wayne, Pennsylvania, USA.