P044 A Profile of New Start IBD Patients on Multiple Advanced/Biologic Therapies.

Abstract

After analyzing patient chart data from nearly 1,000 recently-initiated biologic/JAK inhibitor inflammatory bowel disease (IBD) patients, it was discovered that 6% are treated with multiple advanced/biologic therapies. This analysis sought to profile those new start patients on a multi-biologic/JAK inhibitor regimen against those treated with a single advanced therapy to determine the type of patient who is typically initiated on more than one advanced/biologic therapy, and why the combination is necessary. An independent market analytics firm collaborated with US gastroenterologists (n=197) to conduct a retrospective chart review of patients with inflammatory bowel disease (IBD) (n=999) who were started on a biologic agent for the first time. Gastroenterologists submitted patient-level data via a HIPAA-compliant audit form which included both clinical and non-clinical data. The data were collected and analyzed in April-June 2021. 7% of ulcerative colitis (UC) and 5% of Crohn's disease (CD) patients are currently treated with more than one biologic/JAK inhibitor. The most common therapy used in combination with another for UC is adalimumab (36%), followed by infliximab brand (18%), and ustekinumab (18%). For CD, the most common combinations involve infliximab brand (35%), followed by vedolizumab (22%), and ustekinumab (13%). The necessity for multiple biologic therapy is clarified when reviewing the IBD patients' comorbidities and medical history. The prevalence of ulcerative proctitis (34% vs. 11%) and gastroduodenal CD (43% vs. 4%) among multi-biologic/JAK inhibitor patients is higher than among those treated with one biologic/JAK inhibitor. Additionally, multi-biologic/JAK inhibitor patients have an increased prevalence of recent bowel perforation (16% vs. 1%) and surgical bowel re-section (10% vs. 3%) compared to those treated with just one advanced therapy. Due to this more severe disease profile, patients treated with more than one advanced/biologic therapy are more likely to report severe impairment in work performance (48% vs. 34%), chronic fatigue comorbidity (23% vs. 5%), more frequent ER visits per year (average= 2.3 vs. 1.1), and more frequent hospitalizations per year (2.0 vs. 0.6). A profile of new start biologic IBD patients ideal for concomitant advanced therapy emerged when reviewing almost 1,000 physician-reported patient records. These patients are more likely to have had gastroduodenal Crohn's disease and or recent bowel perforation or re-section. These patients are more likely to report impaired work performance, chronic fatigue, more frequent ER visits and more frequent hospitalizations.