Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use

Objective: The aim of the study was to improve understanding of adherence and persistence to biologics, and their association with health-care resource utilization (HCRU), in Japanese patients with moderate to severe ulcerative colitis (UC). Methods: Data were from Medical Data Vision, a secondary c...

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Autores principales:	Danielle Bargo, Theo Tritton, Joseph C. Cappelleri, Marco DiBonaventura, Timothy W. Smith, Takanori Tsuchiya, Sean Gardiner, Irene Modesto, Tim Holbrook, Daniel Bluff, Taku Kobayashi
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	adherence tumor necrosis factor inhibitor ulcerative colitis health-care resource utilization persistence Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/7a6ded8a8a944227a1c15b6d75bcc505
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spelling	oai:doaj.org-article:7a6ded8a8a944227a1c15b6d75bcc5052021-12-02T12:40:23ZLiving with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use2296-94032296-936510.1159/000519123https://doaj.org/article/7a6ded8a8a944227a1c15b6d75bcc5052021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/519123https://doaj.org/toc/2296-9403https://doaj.org/toc/2296-9365Objective: The aim of the study was to improve understanding of adherence and persistence to biologics, and their association with health-care resource utilization (HCRU), in Japanese patients with moderate to severe ulcerative colitis (UC). Methods: Data were from Medical Data Vision, a secondary care administrative database. A retrospective, longitudinal cohort analysis was conducted of data from UC patients initiating biologic therapy between August 2013 and July 2016. Data collected for 2 years prior (baseline) and 2 years after (follow-up) the index date were evaluated. Patients completing biologic induction were identified, and adherence/persistence to biologic therapy calculated. HCRU, steroid, and immunosuppressant use during baseline and follow-up were assessed. Biologic switching during the follow-up was evaluated. Descriptive statistics (e.g., means and proportions) were obtained and inferential analyses (from Student’s t tests, Fisher’s exact tests, χ2 tests, the Cox proportional hazard model, and negative binomial regression) were performed. Results: The analysis included 649 patients (adalimumab: 265; infliximab: 384). Biologic induction was completed by 80% of patients. Adherence to adalimumab was higher than that to infliximab (p < 0.001). Persistence at 6, 12, 18, and 24 months was higher with infliximab than with adalimumab (p < 0.05). Overall, gastroenterology outpatient visits increased, and hospitalization frequency and duration decreased, from baseline to follow-up. UC-related hospitalizations were fewer and shorter, and endoscopies fewer, in persistent than in nonpersistent patients, although persistent patients made more outpatient visits than nonpersistent patients. Hospitalization duration was lower in persistent than nonpersistent patients. Approximately 50% of patients received an immunosuppressant during biologic therapy; 5% received a concomitant steroid during biologic therapy. Overall, 17% and 3% of patients, respectively, received 2nd line and 3rd line biologics. Conclusions: Poor biologic persistence was associated with increased non-medication-associated HCRU. Effective treatments with high persistence levels and limited associated HCRU are needed in UC.Danielle BargoTheo TrittonJoseph C. CappelleriMarco DiBonaventuraTimothy W. SmithTakanori TsuchiyaSean GardinerIrene ModestoTim HolbrookDaniel BluffTaku KobayashiKarger Publishersarticleadherencetumor necrosis factor inhibitorulcerative colitishealth-care resource utilizationpersistenceDiseases of the digestive system. GastroenterologyRC799-869ENInflammatory Intestinal Diseases, Vol 6, Iss 4, Pp 186-198 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adherence tumor necrosis factor inhibitor ulcerative colitis health-care resource utilization persistence Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	adherence tumor necrosis factor inhibitor ulcerative colitis health-care resource utilization persistence Diseases of the digestive system. Gastroenterology RC799-869 Danielle Bargo Theo Tritton Joseph C. Cappelleri Marco DiBonaventura Timothy W. Smith Takanori Tsuchiya Sean Gardiner Irene Modesto Tim Holbrook Daniel Bluff Taku Kobayashi Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use
description	Objective: The aim of the study was to improve understanding of adherence and persistence to biologics, and their association with health-care resource utilization (HCRU), in Japanese patients with moderate to severe ulcerative colitis (UC). Methods: Data were from Medical Data Vision, a secondary care administrative database. A retrospective, longitudinal cohort analysis was conducted of data from UC patients initiating biologic therapy between August 2013 and July 2016. Data collected for 2 years prior (baseline) and 2 years after (follow-up) the index date were evaluated. Patients completing biologic induction were identified, and adherence/persistence to biologic therapy calculated. HCRU, steroid, and immunosuppressant use during baseline and follow-up were assessed. Biologic switching during the follow-up was evaluated. Descriptive statistics (e.g., means and proportions) were obtained and inferential analyses (from Student’s t tests, Fisher’s exact tests, χ2 tests, the Cox proportional hazard model, and negative binomial regression) were performed. Results: The analysis included 649 patients (adalimumab: 265; infliximab: 384). Biologic induction was completed by 80% of patients. Adherence to adalimumab was higher than that to infliximab (p < 0.001). Persistence at 6, 12, 18, and 24 months was higher with infliximab than with adalimumab (p < 0.05). Overall, gastroenterology outpatient visits increased, and hospitalization frequency and duration decreased, from baseline to follow-up. UC-related hospitalizations were fewer and shorter, and endoscopies fewer, in persistent than in nonpersistent patients, although persistent patients made more outpatient visits than nonpersistent patients. Hospitalization duration was lower in persistent than nonpersistent patients. Approximately 50% of patients received an immunosuppressant during biologic therapy; 5% received a concomitant steroid during biologic therapy. Overall, 17% and 3% of patients, respectively, received 2nd line and 3rd line biologics. Conclusions: Poor biologic persistence was associated with increased non-medication-associated HCRU. Effective treatments with high persistence levels and limited associated HCRU are needed in UC.
format	article
author	Danielle Bargo Theo Tritton Joseph C. Cappelleri Marco DiBonaventura Timothy W. Smith Takanori Tsuchiya Sean Gardiner Irene Modesto Tim Holbrook Daniel Bluff Taku Kobayashi
author_facet	Danielle Bargo Theo Tritton Joseph C. Cappelleri Marco DiBonaventura Timothy W. Smith Takanori Tsuchiya Sean Gardiner Irene Modesto Tim Holbrook Daniel Bluff Taku Kobayashi
author_sort	Danielle Bargo
title	Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use
title_short	Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use
title_full	Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use
title_fullStr	Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use
title_full_unstemmed	Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use
title_sort	living with ulcerative colitis in japan: biologic persistence and health-care resource use
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/7a6ded8a8a944227a1c15b6d75bcc505
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Living with Ulcerative Colitis in Japan: Biologic Persistence and Health-Care Resource Use

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