P1187 Persistence of Advanced Therapies in Patients with Inflammatory Bowel Disease: Retrospective cohort study using large healthcare claims database in Japan

Abstract

Abstract Background Inflammatory bowel disease (IBD) is a lifelong disease and strategically utilizing advanced therapies is essential. Few studies exist to inform the drug utilization of biologics or JAK inhibitors in Japan. The objective is to describe persistence of index and subsequently used biologics or JAK inhibitors in patients with Crohn’s disease (CD) or ulcerative colitis (UC) in Japan. Methods This retrospective cohort study used the Japan Medical Data Center database, which contains claims data from 14 million individuals in Japan. Patients who were diagnosed with CD or UC, and received advanced therapy, including biologics and JAK inhibitors, between January 1, 2010 and September 30, 2022 were included. Patients aged at least 15 years old were required to have no treatment with advanced therapies within 6-month prior to the initiation of index treatments of interest: adalimumab, infliximab, vedolizumab, golimumab, ustekinumab and tofacitinib for CD and UC in Japan. Persistence was defined as having continuous treatment with each therapy over a specified follow-up period (i.e., 6 months, 12 months, 18 months, or 24 months since the index date), without the presence of a pre-defined treatment gap, i.e., 1.5 times the number of days covered by the prior day’s supply. Results The numbers of eligible patients with CD and UC during the study period were 1,115 and 1,942, respectively. Among patients with CD, the distribution of index treatment for adalimumab, infliximab, ustekinumab and vedolizumab was 41.4%, 37.4%, 18.2%, and 3.0%, respectively. Among patients with UC, the distribution of index treatment for infliximab, adalimumab, vedolizumab, golimumab, tofacitinib and ustekinumab was 33.6%, 24.8%, 17.5%, 11.2%, 7.3% and 5.6%, respectively. For CD cohort, persistence of ustekinumab was numerically highest in all periods (94.7% at 6 months, 91.3% at 12 months, 88.2% at 18 months and 80.4% at 24 months), followed by infliximab (94.1%, 87.7%, 82.0% and 76.8%, respectively). For UC cohort, highest persistence was observed in ustekinumab through all periods (95.1% at 6 months, 84.0% at 12 months, 81.6% at 18 months and 75.0% at 24 months), followed by vedolizumab (82.0%, 69.7%, 64.2% and 59.4%, respectively). As subsequent treatments, persistence of ustekinumab and infliximab were comparable for CD while the highest persistence was observed for ustekinumab through all periods for UC. Conclusion Persistence of advanced IBD treatments available in Japan was investigated. As an index treatment, ustekinumab maintained high persistence through 2 years from the index date both in CD and UC. This data provides valuable information on the management of patients living in Japan with IBD under real-world setting.