Real-World Data Shows Longest Persistence for Vedolizumab in Ulcerative Colitis

ulcerative colitis
Researchers examined biologic treatment patterns in patients with ulcerative colitis who were bio-naïve and bio-experienced.

Patients with ulcerative colitis (UC) had the highest persistence to vedolizumab (VDZ), according to study findings published in Current Medical Research and Opinion.

Investigators with STATinMED Research and Janssen Scientific Affairs sourced data for this study from IBM® Market Scan® (2014-2018), Optum Clinformatics™ (2014-2019), and IQVIA PharMetrics Plus™ (2014-2018). Persistence of adalimumab (ADA), golimumab (GOL), infliximab (IFX), or VDZ was evaluated among patients with UC. A gap of fewer than 28 days (ADA), fewer than 56 days (GOL), or fewer than 112 days (IFX or VDZ) was defined as persistence. The Medication Possession Ration (MPR) was defined as the sum of days with drug supply divided by the total number of days in a 12-month follow-up period and an MRP greater than or equal to 0.8 was considered to be adherent.

There were 3102 bio-naïve and 369 bio-experienced patients who took ADA, 246 naïve and 210 experienced patients who took GOL, 1885 naïve and 524 experience patients who took IFX, and 873 naïve and 1019 experienced patients who took VDZ. The patient cohorts had a mean age of 39.2 to 41.2 years, 36.0% to 42.3% were women, and the Charlson comorbidity index was 0.6 to 0.8.

Persistence was highest among the VDZ naïve cohort (78.5%), followed by VDZ-experienced (78.4%), IFX-naïve (72.7%), IFX-experienced (70.2%), GOL-naïve (53.7%), ADA-experienced (49.3%), ADA-naïve (48.7%), and GOL-experienced (47.6%) groups.

The highest discontinuation rate was observed in the GOL-experienced group (52.4%) and lowest in the VDZ-naïve group (21.5%). The switch rate was highest in the GOL-naïve group (22.0%) and lowest in the VDZ-experienced group (4.5%).

The proportion of patients who discontinued without restart or switch was lowest in the VDZ-naïve cohort (11.7%), followed by IFX-naïve (13.7%), VDZ-experienced (14.4%), IFX-experienced (14.9%), GOL-naïve (17.1%), ADA-naïve (17.3%), ADA-experienced (19.5%), and GOL-experienced (26.7%) groups.

Adherence among the naïve and experienced groups was highest for the VDZ cohort (71.9% vs 71.8%), followed by IFX (65.5% vs 67.0%), ADA (57.5% vs 57.7%), and GOL (52.4% vs 45.2%) groups, respectively.

Fewer of the naïve cohorts had a 50% dose escalation in the ADA (13.0% vs 16.1%), VDZ (8.1% vs 9.9%), and GOL (1.6% vs 2.6%) cohorts. Less than 1% of any group had a 50% dose reduction.

Study limitations included not having access to data about motivations for drug discontinuation or switching.

The study authors concluded that real-world data from patients with UC found that persistence was highest for VDZ followed by IFX, GOL, and ADA.

“This real-world study of UC patients provides further insight into the treatment patterns of the biologics approved for UC during the study period,” the study authors wrote. “While these analyses were descriptive in nature, our findings suggest that there is room for improvement in adherence rates across the treatment options studied.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical,

and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Sah J, Teeple A, Muser E, Gutierrez C, Dassopoulos T. Treatment persistence and maintenance dose titration among ulcerative colitis on biologics: a pooled study of three United States claim databases. Curr Med Res Opin. Published online May 23, 2022. doi:10.1080/03007995.2022.2071041