S838 Infusible Biologics in Gastroenterology Physician Clinics Were Not Impacted by the COVID-19 Pandemic

Abstract

Introduction: The COVID-19 pandemic drastically changed the provision of outpatient healthcare services. Patients on infusible biologics for inflammatory bowel disease (IBD) were advised to continue therapy to prevent disease relapse and consequential healthcare exposure. There was little guidance for patients scheduled to begin infusions, and facility closures further complicated therapy options. The purpose of this study is to describe the impact of COVID-19 on IBD patients initiating infusible biologic therapy in an outpatient gastroenterology physician clinic setting. Methods: We conducted a retrospective analysis of all IBD patients started on infliximab (IFX) and vedolizumab (VDZ) therapy from January 1st to June 30th, 2020 at large multicenter gastroenterology private practices in Texas. The same clinics and time period in 2019 were used as a comparator. Data collection consisted of demographics, referral dates, infusion dates, and clinical outcomes between referral and first infusion. Evaluation of outcome measures including IBD flare symptoms, corticosteroid use, and healthcare utilization is ongoing. Primary outcomes were the number of new-starts and adherence to infusible biologics during the pandemic. Infusions administered beyond 3 days for induction dosing and 7 days for maintenance dosing were considered delayed. Results: There were 258 patients (122 IFX, 136 VDZ) and 222 patients (99 IFX, 123 VDZ) initiated on infusible biologics in 2020 and 2019, respectively [Table 1]. Median time from referral to first infusion was 33 days (IQR 23-50) in 2020, compared to 29 days (IQR 22-45) in 2019 (p=0.08). A total of 859 infusions were administered from January 1st to June 30th, 2020 and 713 infusions were administered in the same time period in 2019. Infusion delays were experienced by 70 (27%) patients in 2020 and 61 (27%) patients in 2019 (p=0.93). There were 104 (12%) delayed infusions in 2020 and 71 (10%) delayed infusions in 2019 (p=0.18) [Figure 1]. No significant differences in induction infusion delays (11% in 2020 vs. 9% in 2019, p=0.42) or maintenance infusion delays (18% in 2020 vs. 13% in 2019, p=0.24) year-over-year were seen. Conclusion: We observed a comparable number of patients initiated on IFX and VDZ in 2020 versus the previous year. Additionally, there were no significant delays in therapy. Even with global challenges in the provision of healthcare services, the outpatient gastroenterology physician clinics were able to successfully treat patients during the COVID-19 pandemic.Figure 1.: Delayed Infusions of Infusible Biologics in 2020 vs. 2019.Table 1.: Infusible Biologics in Gastroenterology Physician Clinics in 2020 vs. 2019.