Real-World Treatment Patterns and Physician Preferences for Biologics in Moderate-to-Severe Inflammatory Bowel Disease: Retrospective Chart Review in Europe. Issue 1 (27th January 2022)

• Record Type: Journal Article
• Authors: Huynh, Lynn; Hass, Steve; Peyrin-Biroulet, Laurent; Duh, Mei Sheng; Sipsma, Heather; Cheng, Mu; Lax, Angie; Nag, Arpita
• Is Part Of: Crohn's & colitis 360. Volume 4:Issue 1(2022)
• Publication Date: 2022-01-27
• Subjects: biological therapy -- biosimilar pharmaceuticals -- ulcerative colitis -- Crohn's disease -- physicians' practice patterns; Crohn's disease -- Periodicals; Colitis -- Periodicals; 616.344
• DOI: 10.1093/crocol/otac001
• Languages: English
• ISSNs: 2631-827X

Abstract

Abstract: Background: With many options available for treating inflammatory bowel disease (IBD) in Europe, this study sought to characterize physician treatment preferences and real-world treatment patterns in patients with moderate-to-severe ulcerative colitis (UC) and Crohn's disease (CD). Methods: This was a retrospective, noninterventional, physician-administered study. Gastroenterologists and general practitioners ( n = 348) in France, Germany, and the United Kingdom provided information on treatment preferences and extracted information from records of patients with moderate-to-severe UC ( n = 587) or CD ( n = 417) who had received biologic, biosimilar or Janus kinase inhibitor therapies (2014–2019) and had IBD-related medical history available 6 months before and after treatment initiation. Results: Physicians largely preferred infliximab and adalimumab or their biosimilars as first-line therapy for UC (originators, 65.8%; biosimilars, 26.1%) and CD (originators, 61.8%; biosimilars, 30.5%). Effectiveness was the most cited reason for treatment preference (92%–93% of physicians). Three-quarters of patients (UC, 75.8%; CD, 73.6%) received infliximab or adalimumab originators in the first line, with more patients receiving infliximab biosimilars than adalimumab biosimilars (12.4%–12.5% and 0.5%–4.1%, respectively, across UC and CD). Persistence was longer for first-line infliximab than adalimumab (UC, 26.6 vs 21.2 months; CD, 31.2 vs 26.7 months) and was generally shorter for their respective biosimilars. Nonbiologic treatments were used in combination with biologics in 14.1% (UC) and 11.5% (CD) of patients. Most patients received 1 biologic therapy (UC, 90.6%; CD, 83.2%); only 9.4% (UC) and 16.8% (CD) received a second biologic. Conclusions: Infliximab and adalimumab originators dominated first-line biologic therapy for moderate-to-severe UC and CD. Understanding real-world treatment patterns can help assess new treatment uptake and suggest opportunities for improving treatment. Lay Summary: In everyday clinical practice in France, Germany, and the United Kingdom, patients with moderate-to-severe inflammatory bowel disease received first-line biologic therapy in line with current treatment guidelines and physician preferences, with originator biologics dominating the treatment landscape for these patients.