Superior treatment persistence with ustekinumab in Crohn's disease and vedolizumab in ulcerative colitis compared with anti‐TNF biological agents: real‐world registry data from the Persistence Australian National IBD Cohort (PANIC) study. Issue 3 (20th June 2021)

• Record Type: Journal Article
• Authors: Ko, Yanna; Paramsothy, Sudarshan; Yau, Yunki; Leong, Rupert W.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 54:Issue 3(2021)
• Page Start: 292
• Page End: 301
• Publication Date: 2021-06-20
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.16436
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: Medication persistence contributes real‐world evidence about treatment effectiveness, tolerability and prescriber and patient acceptability. Aims: To evaluate persistence of biological agents in Crohn's disease (CD) and ulcerative colitis (UC) and the effects of immunomodulator use and treatment lines. Methods: Retrospective national population‐based data on treatment persistence for adalimumab, infliximab vedolizumab and ustekinumab for CD and UC were analysed from the Australian Pharmaceutical Benefits Scheme using Kaplan‐Meier analysis and Cox proportional hazards models. Results: There were 2499 patients included with 8219 person‐years of follow‐up. In CD patients ustekinumab had increased persistence compared to anti‐TNF agents (HR: 1.79, 95%CI: 1.32‐2.38, P < 0.01). Twelve‐month CD persistence rates were ustekinumab 80.0%, vedolizumab 73.5%, infliximab 68.1% and adalimumab 64.2% ( P = 0.01). In moderate‐severe UC vedolizumab had increased persistence compared to anti‐TNF agents (HR: 1.67, 95% CI: 1.27‐2.18 P < 0.001). Twelve‐month UC persistence rates were vedolizumab 73.4%, infliximab 61.1% and adalimumab 45.5% ( P < 0.001). Immunomodulator co‐therapy did not significantly increase persistence in non‐anti‐TNF therapy ( P > 0.05). Thiopurines increased persistence of anti‐TNF agents in CD ( P < 0.001) and UC ( P = 0.03). Methotrexate co‐therapy increased persistence of anti‐TNF agents in CD ( P = 0.001) only. First‐line therapy was superior to non‐first line in persistence ( P < 0.001). In fistulising CD, the persistence of infliximab and adalimumab was not significantly different ( P = 0.11). Conclusion: Persistence was highest in ustekinumab in CD and vedolizumab in UC. Factors which increased the persistence of biological agents are first‐line therapy, and immunomodulator co‐therapy in anti‐TNF agent use. Abstract : Treatment persistence in Crohn's disease and ulcerative colitis ‐ data from the PANIC registry. Superior persistence with ustekinumab in Crohn's disease and vedolizumab in ulcerative colitis. Thiopurine co‐therapy increases persistence with anti‐TNF agents.