D0372 - Evaluation of Treatment Patterns Among Crohn’s Disease Patients Initiating Biologics With Three Years of Follow-Up

Tuesday, October 25, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

SK

Sumesh Kachroo, PhD

Janssen Scientific Affairs, LLC
Horsham, Pennsylvania

Ruizhi Zhao, PhD¹, Zhijie Ding, PhD, MS¹, Parul Gupta, PhD², Laurence Gozalo, PhD, MBA², Robert Bruette, MA², Victor Johnson, MA², Keshia Maughn, MPH², Sumesh Kachroo, PhD¹
¹Janssen Scientific Affairs, LLC, Horsham, PA; ²STATinMED Research, Plano, TX

Introduction: This study examined biologic treatment patterns among Crohn’s Disease (CD)-related patients initiating biologics over a 3-year follow-up period.

Methods: This descriptive study used All Payers Claims Data (APCD) from Sep 2015 to Oct 2021. Adult patients with ≥1 CD medical claim and ≥1 medical/pharmacy claim for a biologic (adalimumab [ADA], certolizumab pegol [CZP], infliximab [IFX] and its biosimilar products [IFX-BS], ustekinumab [UST], and vedolizumab [VDZ]) during Sep 2016 to Oct 2018 were selected. Index date was the first biologic claim date. Patients had continuous capture with commercial insurance for ≥12 months pre (baseline) and ≥36 months post index date (follow-up). Using a claims-based algorithm, confirmed CD patients were included in the final cohort. A persistent patient was one that remained on the index biologic without a gap of >60 days for ADA and CZP, and of >120 days for UST, IFX, IFX-BS, and VDZ between run-out dates of two sequential biologic claims. Patients who discontinued were classified as switchers (to another biologic), restarters (restarted index biologic), or discontinuers without switch and restart during follow-up.

Results: A total of 2,309 CD patients were identified (394 [17.1%] UST, 847 [36.7%] IFX, 72 [3.1%] IFX-BS, 534 [23.1%] ADA, 85 [3.7%] CZP, and 486 [21.1%] VDZ). Due to a small sample size, CZP and IFX-BS groups were excluded in further analyses. Approximately half of the CD patients were between age 35 to 54. Patients on UST and VDZ had numerically higher Charlson comorbidity index score at baseline. Common comorbidities among CD patients at baseline included anemia, anxiety, depression, fatigue, and hypertension (Table 1). UST [61.4%] patients had the highest persistence rate numerically in year 3 after treatment initiation, followed by VDZ [58.0%], ADA [52.1%], and IFX [48.1%] (Figure 1). Numerically, UST [18.8%] had the lowest switch rate, followed by VDZ [24.5%], ADA [26.6%], and IFX [32.9%].

Discussion: UST had the highest persistence and lowest switch rate numerically in year 3 after treatment initiation among patients with CD.

Figure: Persistence Among Crohn's Disease Patients Using Biologics Over3 Years of Follow-up*

Characteristics	Adalimumab (N=534)	Infliximab (N=847)	Ustekinumab (N=394)	Vedolizumab (N=486)
Age, mean	43.5	43.7	44.0	45.3
Age group, years
18-34	24.0%	26.4%	25.6%	20.0%
35-54	52.4%	47.2%	48.5%	52.3%
55-64	23.6%	26.3%	25.9%	27.8%
Sex
Male	45.7%	42.0%	46.7%	43.6%
Female	54.3%	58.0%	53.3%	56.4%
US geographic region
Northeast	14.0%	19.0%	17.5%	19.5%
North Central	33.1%	33.1%	37.3%	35.2%
South	37.6%	30.7%	30.5%	31.5%
West	15.2%	17.2%	14.7%	13.8%
Index Year
2016	14.2%	13.2%	7.9%	13.4%
2017	56.7%	55.1%	53.0%	51.4%
2018	29.0%	31.6%	39.1%	35.2%
Charlson comorbidity index score	0.5	0.5	0.7	0.6
Comorbidities
Anemia	17.4%	16.9%	30.2%	21.0%
Anxiety	14.0%	12.8%	19.8%	17.5%
Atherosclerosis	0.2%	0.5%	0.5%	0.0%
Celiac disease	1.1%	2.1%	6.1%	2.9%
Cholelithiasis	0.6%	0.0%	0.3%	0.2%
Chronic pain	5.8%	4.7%	8.9%	8.2%
Depression	14.2%	12.4%	18.3%	17.3%
Diabetes	6.2%	6.3%	7.4%	7.2%
Fatigue	7.7%	8.6%	14.2%	11.3%
Fistula	3.4%	6.7%	6.3%	6.0%
Hyperlipidemia	9.2%	9.3%	9.6%	10.7%
Hypertension	18.9%	15.7%	20.3%	17.5%
Obesity	10.1%	9.4%	11.7%	9.9%
Venous Thromboembolism	0.7%	1.5%	2.8%	1.6%

Table: Descriptive Baseline Characteristics Among Crohn’s Disease Patients

Disclosures:

Ruizhi Zhao: Janssen Scientific Affairs LLC – Employee.

Zhijie Ding: Janssen Scientific Affairs, LLC – Employee. Janssen Scientific Affairs, LLC – Employee. Janssen Scientific Affairs, LLC – Stock Options, Stock-publicly held company(excluding mutual/index funds).

Parul Gupta: Janssen Scientific Affairs, LLC – I am a paid employee of STATinMED Research which is a paid consultant to Janssen Scientific Affairs, LLC..

Laurence Gozalo: Janssen Scientific Affairs, LLC – I am a paid employee of STATinMED Research which is a paid consultant to Janssen Scientific Affairs, LLC..

Robert Bruette: Janssen Scientific Affairs, LLC – I am a paid employee of STATinMED Research which is a paid consultant to Janssen Scientific Affairs, LLC..

Victor Johnson: Janssen Scientific Affairs, LLC – I am a paid employee of STATinMED Research which is a paid consultant to Janssen Scientific Affairs, LLC..

Keshia Maughn: Janssen Scientific Affairs, LLC – I am a paid employee of STATinMED Research which is a paid consultant to Janssen Scientific Affairs, LLC..

Sumesh Kachroo: Johnson and johnson family of companies – Employee. Johnson and Johnson family of companies – Employee, Stock Options. Johnson and johnson family of companies – Stock Options.

Ruizhi Zhao, PhD¹, Zhijie Ding, PhD, MS¹, Parul Gupta, PhD², Laurence Gozalo, PhD, MBA², Robert Bruette, MA², Victor Johnson, MA², Keshia Maughn, MPH², Sumesh Kachroo, PhD¹. D0372 - Evaluation of Treatment Patterns Among Crohn’s Disease Patients Initiating Biologics With Three Years of Follow-Up, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.