P0508 - Temporal Trends of Utilization of Biologics as First-Line Therapy in the Management of Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Study

Ahmed Eltelbany, MD, MPH¹, Abdul Mohammed, MD², Osama Hamid, MD¹, George Khoudari, MD¹, Miguel Regueiro, MD^3
1Cleveland Clinic Foundation, Cleveland, OH; ²MetroHealth Medical Center, Cleveland, OH; ³Cleveland Clinic, Cleveland, OH

Introduction: Inflammatory Bowel Disease (IBD) treatment has changed significantly over the past decade with biologics initiated earlier. Recent data suggest that early initiation of biologics could be more beneficial to patients. Our study investigates the trends of utilization of biologics as a first line therapy agents in the management of both Crohn’s Disease (CD) and Ulcerative Colitis (UC) patients from 2010 to 2020.

Methods: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine – Clinical Terms (SNOMED-CT), we identified all patients (age >18 years) who were diagnosed with either CD or UC between 2010 and 2020 and then treated with any type of biologics as a first line agent. The biologic group included Adalimumab, Certolizumab pegol, Golimumab, Infliximab, Natalizumab, Ustekinumab & Vedolizumab. We did not exclude patients who were received corticosteroids.

Results: Of the 59,936,800 individuals in the database from 2010 to 2020. We identified 182,310 (0.30%) patients with CD and 148,300 (0.25%) patients with UC, of which 20,790 (11.4%) and 10,400 (7.0%) patients received biologics as a first line therapy, respectively. The utilization of biologics as first line therapy in the management of CD progressively increased from 4.9% in 2010 to 13.7% in 2020. Similarly, the utilization of biologics as first line therapy in the management of UC progressively increased from 2.0% in 2010 to 7.3% in 2020. Overall, patients with CD were 1.71 times more likely to be started on biologics as a first line therapy compared to patients with ulcerative colitis (CI 1.67 - 1.75, < 0.0001). Furthermore, Infliximab was the biologic agent of choice in both CD and UC accounting for 40.5% of all biologics.

Discussion: This is the largest individual study investigating the trends of utilization of biologics as first line therapy agents in inflammatory bowel disease. Our findings suggest a possible paradigm shift in IBD management as we found that patients with inflammatory bowel disease are increasingly more likely to be treated with a biologic agent as a first line therapy. Furthermore, patients with Crohn’s Disease patients were significantly more likely to receive biologics as first line therapy compared to patients with Ulcerative Colitis.




Disclosures:


Ahmed Eltelbany, MD, MPH¹, Abdul Mohammed, MD², Osama Hamid, MD¹, George Khoudari, MD¹, Miguel Regueiro, MD³. P0508 - Temporal Trends of Utilization of Biologics as First-Line Therapy in the Management of Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.