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Outcomes in patients with IBD stratified by risk of disease progression
Tao Fan, Jeanne Jiang1, Chiahung Chou
1Global Medical Evidence, Takeda Pharmaceuticals USA, Inc, 500 Kendall St, Cambridge, MA 02142.
Insights
Risk stratification for Crohn disease (CD) and ulcerative colitis (UC) using claims data identified high-risk patients with increased healthcare use. Early advanced therapy may benefit these patients.
Area of Science:
- Gastroenterology
- Health Services Research
- Data Science
Background:
- Crohn disease (CD) and ulcerative colitis (UC) management can be improved by risk stratification.
- Identifying patients at high risk for disease progression and high healthcare resource utilization (HCRU) is crucial.
Purpose of the Study:
- To characterize patients with CD or UC as high or low risk for disease progression.
- To estimate CD- and UC-related HCRU based on risk stratification.
Main Methods:
- Retrospective analysis of US healthcare claims data (2017-2019).
- Included patients (≥18 years) with CD or UC, naive to biologic treatment.
- Risk stratification used American Gastroenterological Association criteria.
Main Results:
- For CD: 39.1% high-risk, 60.9% low-risk. High-risk CD patients had more hospitalizations and surgeries.
- For UC: 40.4% high-risk, 59.6% low-risk. High-risk UC patients had more hospitalizations and surgeries.
- High-risk patients in both groups received advanced therapy more frequently.
Conclusions:
- Healthcare claims data can be utilized for prognostic risk stratification in CD and UC.
- This approach can identify patients who may benefit from early intervention with advanced therapies.
Objectives:
Risk stratification of patients with Crohn disease (CD) and ulcerative colitis (UC) may improve outcomes and health care resource utilization (HCRU). We characterized patients with CD or UC as being at high or low risk of disease progression and estimated rates of CD-related and UC-related HCRU.
Study Design:
This retrospective study used claims data from a US health care payer database from January 1, 2017, to December 31, 2019.
Methods:
Included patients were fully insured, were 18 years or older, had a diagnosis of CD or UC, and were naive to biologic treatment. Patients were stratified as being at high or low risk of disease progression and associated HCRU using a priori definitions based on American Gastroenterological Association criteria.
Results:
For CD, 1459 (39.1%) patients were high risk and 2272 (60.9%) patients were low risk. High-risk patients had higher mean hospitalizations (0.35 vs 0.28; P = .03) and surgeries (0.04 vs 0.01; P < .0001) per patient than low-risk patients. During follow-up, 13.8% of patients with CD at high risk received advanced therapy vs 4.8% of low-risk patients. For UC, 2215 (40.4%) patients were high risk and 3270 (59.6%) patients were low risk. High-risk patients had higher mean hospitalizations (0.33 vs 0.10; P < .0001) and surgeries (0.01 vs 0.00; P < .0001) per patient than low-risk patients. During follow-up, 7.7% of patients with UC at high risk received advanced therapy vs 1.8% of low-risk patients.
Conclusions:
Health care claims data may be used for prognostic risk stratification in CD and UC and to identify patients who may benefit from early treatment with advanced therapies.
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