Real-World Treatment Outcomes Associated With Early Versus Delayed Vedolizumab Initiation in Patients With Ulcerative Colitis.

IF 1.8 Q3 GASTROENTEROLOGY & HEPATOLOGY Crohn's & Colitis 360 Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI:10.1093/crocol/otae061
Noa Krugliak Cleveland, Ninfa Candela, John A Carter, Maja Kuharic, Joyce Qian, Zhaoli Tang, Robin Turpin, David T Rubin
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引用次数: 0

Abstract

Background: Patients with ulcerative colitis (UC) typically receive a targeted inflammatory bowel disease therapy after treatment with conventional therapies and after the development of significant morbidity. Evidence suggests that early biologic treatment after diagnosis could improve treatment response and prevent disease complications compared with delayed biologic treatment after conventional therapy.

Methods: RALEE was a retrospective study using claims data from IBM® MarketScan® Research Databases between January 1, 2016 and December 31, 2019. Adults with UC and at least one claim for vedolizumab were categorized into Early or Delayed Vedolizumab groups according to whether they had received vedolizumab within 30 days of diagnosis or after conventional therapy (5-aminosalicylates, corticosteroids, and immunomodulators), respectively. Treatment response was assessed at 2, 6, and 12 months after vedolizumab treatment initiation and was analyzed with logistic regression (bivariate).

Results: At 2 months, Delayed Vedolizumab was associated with significantly higher odds of nonresponse than Early Vedolizumab (odds ratio [OR], 2.509; 95% confidence interval [CI], 1.28-4.90). Delayed Vedolizumab was not significantly associated with odds of nonresponse at 6 months (OR, 1.173; 95% CI, 0.72-1.90) or at 12 months (OR, 0.872; 95% CI, 0.55-1.37). Mean total healthcare costs were similar in the Early Vedolizumab ($6492) and Delayed Vedolizumab ($5897) groups, although there were small differences in costs from different types of claims.

Conclusions: Patients who received vedolizumab early after UC diagnosis were less likely to experience nonresponse at 2 months and incurred similar healthcare costs at 12 months compared with patients who received delayed vedolizumab.

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溃疡性结肠炎患者早期使用维多珠单抗与延迟使用维多珠单抗的实际治疗效果对比
背景:溃疡性结肠炎(UC)患者通常在接受常规疗法治疗后,在出现严重并发症后接受炎症性肠病靶向治疗。有证据表明,与常规治疗后延迟生物治疗相比,诊断后早期生物治疗可改善治疗反应并预防疾病并发症:RALEE 是一项回顾性研究,使用的是 2016 年 1 月 1 日至 2019 年 12 月 31 日期间 IBM® MarketScan® 研究数据库中的理赔数据。根据 UC 患者是否在确诊后 30 天内或在常规治疗(5-氨基水杨酸盐、皮质类固醇激素和免疫调节剂)后接受了维多珠单抗治疗,将其分为早期维多珠单抗组和延迟维多珠单抗组。在维多珠单抗治疗开始后的2、6和12个月对治疗反应进行评估,并采用逻辑回归(双变量)进行分析:结果:2个月时,延迟维多珠单抗的无应答几率明显高于早期维多珠单抗(几率比 [OR],2.509;95% 置信区间 [CI],1.28-4.90)。延迟韦多珠单抗与6个月无应答几率(OR,1.173;95% CI,0.72-1.90)或12个月无应答几率(OR,0.872;95% CI,0.55-1.37)无显著相关性。早期维多利珠单抗组(6492美元)和延迟维多利珠单抗组(5897美元)的平均医疗总费用相似,但不同类型索赔的费用差异较小:结论:与延迟接受维多珠单抗治疗的患者相比,UC确诊后早期接受维多珠单抗治疗的患者在2个月内出现无应答的可能性较小,在12个月内产生的医疗费用相似。
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来源期刊
Crohn's & Colitis 360
Crohn's & Colitis 360 Medicine-Gastroenterology
CiteScore
2.50
自引率
0.00%
发文量
41
审稿时长
12 weeks
期刊最新文献
Real-World Treatment Outcomes Associated With Early Versus Delayed Vedolizumab Initiation in Patients With Ulcerative Colitis. Like a Punch in the Gut: A Novel Perspective On Annual Recurrences of Ulcerative Colitis. Interventions for Adjunctive Care in Patients With Inflammatory Bowel Disease and Permanent Ileostomy: A Systematic Review. Clinical Approach to STRIDE-II in Real-Life Settings: Analysis and Practical Recommendations. Evaluation of the Symptoms and Clinical Characteristics of Crohn's Disease and Ulcerative Colitis That Affect Healthcare Providers' Treatment Choices.
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