P379 Comparison of real-world treatment outcomes with infliximab vs. vedolizumab in biologic-naïve patients with inflammatory bowel disease. (25th January 2019)

• Record Type: Journal Article
• Authors: Latremouille-Viau, D; Burne, R; Shi, S; Adsul, S; Patel, H
• Is Part Of: Journal of Crohn's and colitis. Volume 13(2019)Supplement 1
• Page Start: S295
• Page End: S296
• Publication Date: 2019-01-25
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjy222.503
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Inflammatory bowel disease (IBD), including ulcerative colitis [UC] and Crohn's disease [CD], is a chronic condition characterised by recurrent episodes of active disease resulting in considerable morbidity. There is a lack of long-term, real-world comparative effectiveness data on biologic-naïve patients with IBD using infliximab (IFX) vs. vedolizumab (VDZ). Methods: A retrospective study on adult patients with IBD who received IFX or VDZ as first biologic (index biologic) between May 2014 (when both biologics were available for moderately/severely active UC/CD treatment [TX]) and September 2018 from the US Explorys Universe database was conducted. Biologic-naïve patients with maintenance TX initiation (≥4 consecutive infusions of the index biologic) were included. Entropy balancing (EB) was used to address potential unbalanced confounding factors. TX persistence, increased dosing frequency, and healthcare resource utilisation (HRU) composite endpoint including IBD-related hospitalisation/surgery or IV corticosteroids (proxy for flares) were compared between IFX and VDZ patients using weighted Kaplan Meier (WKM) analyses. Results: 776 biologic-naïve IBD patients received IFX and 292 VDZ. After EB, mean age was 51 years, 51% were female, 48% were diagnosed with UC, 54% used non-biologic therapies in the 90 days before index biologic initiation, and median time from first IBD diagnosis to index biologic initiation was 3.9 years in both cohorts; 41% IFX and 30% VDZ patients were observed ≥24 mos following TX initiation. Overall, for IFX vs. VDZ, respectively, TX persistence was lower for IFX (WKM rates: 12 months, 78% vs. 87%; 24 months, 62% vs. 80%; all p < 0.05), rates of increased dosing frequency were higher (WKM rates: 12 months, 14% vs. 8%; 24 months, 21% vs. 16%; all p ≤ 0.05), and rates of HRU composite endpoint were higher (WKM rates: 12 months, 48% vs. 41%; 24 months, 59% vs. 54%; all p < 0.05) (Table 1). For UC, IFX patients had significantly higher rates of increased dosing frequency, numerically lower TX persistence and higher rates of HRU composite endpoint vs. VDZ patients. For CD, IFX patients had significantly lower TX persistence and higher rates of HRU composite endpoint, and numerically higher rates of increased dosing frequency vs. VDZ patients. Conclusions: Biologic-naïve IBD patients initiated on VDZ had significantly higher TX persistence, lower rates of increased dosing frequency, and lower rates of HRU composite endpoint, particularly at long-term time points (24 months), compared with those initiated on IFX in a real-world setting.