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Treatment Pathways in Patients With Crohn's Disease and Ulcerative Colitis: Understanding the Road to Advanced
Corey A Siegel1, Dolly Sharma2, Jenny Griffith2
1Inflammatory Bowel Disease Center, Section of Gastroenterology and Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
Crohn'S & Colitis 360
|August 30, 2024
Summary
Few newly diagnosed Crohn's disease (CD) or ulcerative colitis (UC) patients start advanced therapy (AT) first. Most patients cycle through multiple conventional therapies (CT) before initiating AT, indicating treatment pattern gaps.
Area of Science:
- Gastroenterology
- Clinical Pharmacy
- Health Services Research
Background:
- Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases.
- Patients often undergo multiple conventional therapies (CT) before advanced therapy (AT).
- Understanding treatment patterns is crucial for optimizing patient care.
Purpose of the Study:
- To describe treatment patterns among adult patients with CD and UC.
- To analyze first-line treatment choices and CT pathways before AT initiation.
Main Methods:
- Retrospective analysis of Merative MarketScan Research databases (2017-2021).
- Identified adult patients with CD/UC based on medical/pharmacy claims.
- Established two cohorts: newly diagnosed and initiating AT.
Main Results:
- Few newly diagnosed patients initiated AT; most started corticosteroids.
- Patients initiated AT after a mean of 4.0 (CD) and 5.9 (UC) CT episodes.
- Significant proportions cycled through multiple mechanisms of action (MOA) before AT.
Conclusions:
- Newly diagnosed CD/UC patients rarely initiate AT first-line.
- Patients experience extensive conventional therapy cycling before AT.
- Current treatment patterns may not align with optimal therapeutic strategies.
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