克罗恩病和溃疡性结肠炎患者的治疗途径:了解通往高级疗法之路。

IF 1.8 Q3 GASTROENTEROLOGY & HEPATOLOGY Crohn's & Colitis 360 Pub Date : 2024-08-20 eCollection Date: 2024-07-01 DOI:10.1093/crocol/otae040
Corey A Siegel, Dolly Sharma, Jenny Griffith, Quynhchau Doan, Si Xuan, Lisa Malter
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引用次数: 0

摘要

背景:克罗恩病(CD)或溃疡性结肠炎(UC)患者在开始接受晚期治疗(AT)之前,通常会循环使用不同作用机制(MOA)的常规疗法(CT)。我们描述了 CD/UC 患者的治疗模式:利用 Merative MarketScan Research 数据库,从医疗/药店索赔(2017-2021 年)中识别出 CD/UC 成年患者。患者因 CD/UC 住院≥1 次或门诊≥2 次(1 年内相隔≥30 天)。建立了两个队列:队列 1:新诊断患者(索引日期为首次诊断日期);队列 2:开始 AT 的患者(索引日期为首次 AT 日期)。报告了一线治疗模式(队列 1)和开始 AT 前的 CT 途径(队列 2)的发作次数(即增加一种新疗法、改用另一种疗法或≥60 天后重新开始同一种疗法)和 MOA:在队列 1(CD:n = 1739;UC:n = 2740)的新诊断患者中,14.4%(CD)和 5.9%(UC)的患者在随访期间(平均:2.3 年;≥ 77% 开始使用皮质类固醇激素)使用过任何 AT。在队列 2 的患者中(CD:n = 2594;UC:n = 2431),开始使用 AT 前 CT 发作的平均次数为 4.0 ± 4.3(CD)和 5.9 ± 5.0(UC)。在皮质类固醇发作次数≥1 次的患者中(CD:82.2%;UC:91.5%),平均发作次数为 4.6 ± 4.3(CD)和 6.3 ± 5.0(UC)。总体而言,13.3%(CD)和23.7%(UC)的患者在开始使用AT前循环使用了3种MOA:结论:尽管有治疗建议,但很少有新诊断的CD/UC患者将AT作为首次治疗。结论:尽管有治疗建议,但很少有新诊断的 CD/UC 患者将 AT 作为首次治疗。
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Treatment Pathways in Patients With Crohn's Disease and Ulcerative Colitis: Understanding the Road to Advanced Therapy.

Background: Patients with Crohn's disease (CD) or ulcerative colitis (UC) often cycle through conventional therapies (CT) with different mechanisms of action (MOA) before initiating advanced therapy (AT). We describe treatment patterns among patients with CD/UC.

Methods: Using Merative MarketScan Research databases, adult patients with CD/UC were identified from medical/pharmacy claims (2017-2021). Patients had ≥1 hospitalization or ≥2 outpatient visits (≥30 days apart within 1 year) for CD/UC. Two cohorts were established; cohort 1: Newly diagnosed patients (index date is the date of first diagnosis) and cohort 2: Patients initiating AT (index date is the date of first AT). First-line treatment patterns (cohort 1) and CT pathways before AT initiation (cohort 2) by the number of episodes (ie, adding a new therapy, switching to another therapy, or restarting the same therapy after ≥60 days) and MOA are reported.

Results: Among newly diagnosed patients in cohort 1 (CD: n = 1739; UC: n = 2740), 14.4% (CD) and 5.9% (UC) of patients had any AT use during the follow-up period (mean: 2.3 years; ≥ 77% initiated corticosteroids). Among patients in cohort 2 (CD: n = 2594; UC: n = 2431), the mean number of CT episodes before AT initiation was 4.0 ± 4.3 (CD) and 5.9 ± 5.0 (UC). Among those with ≥1 corticosteroid episode (CD: 82.2%; UC: 91.5%), the mean number of episodes was 4.6 ± 4.3 (CD) and 6.3 ± 5.0 (UC). Overall, 13.3% (CD) and 23.7% (UC) of patients cycled through 3 MOAs before AT initiation.

Conclusions: Despite treatment recommendations, few newly diagnosed CD/UC patients initiated AT as their first treatment. Moreover, patients cycled through multiple CTs before initiating AT.

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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
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