P163 TRANSITION TO BIOLOGIC HOME INFUSIONS IN IBD PATIENTS IS ASSOCIATED WITH HIGH DROP OUT WITHIN ONE YEAR. (18th January 2018)

• Record Type: Journal Article
• Authors: Fenster, Marc; Gallinger, Zane; Paramsothy, Sudarshan; Hirten, Robert; Cohen, Louis; Oikonomou, Ioannis; Mehandru, Saurabh; Colombel, Jean-Frederic; Ungaro, Ryan; Cohen, Benjamin
• Is Part Of: Inflammatory bowel diseases. Volume 24(2018)Supplement 1
• Page Start: S61
• Page End: S61
• Publication Date: 2018-01-18
• Subjects: Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izy037.036
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: Introduction: Optimal inflammatory bowel disease (IBD) therapy often requires biologic medications delivered by intravenous (IV) infusion. Until recently, infusions were generally delivered in supervised hospital or outpatient clinics. As insurance companies attempt to minimize costs, IV infusions are being transitioned into patient homes. Limited data exists on the safety, effectiveness and experience of home infusion (HI) programs. Methods: We conducted a retrospective cohort study of patients started on HI with infliximab or vedolizumab. Disease specific data and frequency of stopping HI was abstracted. Potential factors associated with stopping HI were assessed using Fisher's exact test and Kaplan Meier survival curves with log-rank tests. Results: Sixty-nine patients started HI during the study period with median follow-up of 303 days (table 1). Most patients (89.9%) transitioned from an infusion center to HI. Eighteen patients (26.1%) stopped HI in median 154 days. Among the patients who stopped HI, 50% transitioned back to an infusion center and 50% stopped therapy. Poor experiences were noted as the reason for stopping HI in 27.8% (Table 2). Five patients developed anti-drug antibodies leading to therapy cessation in 3. Three patients developed acute infusion reactions. Time to stopping HI or therapy was not associated with gender, IBD type, infusion medication, concomitant use of immunomodulator, prior biologic exposure, baseline CRP, or active endoscopic disease at start of HI. Conclusions: This is the first study to investigate the experience of a cohort of patients receiving infliximab or vedolizumab at home. Interestingly, over 25% of patients in our cohort stopped their HI within the first year; only half due to treatment failure. Poor patient experience was the most common non-treatment failure cause for stopping HI. While HI may provide added convenience and decrease costs, further research is needed to determine the safety of switching to HI.