Wod, M [1,2], Abed, OK [3], Godskesen LE [3], Larsen, MD [1,4], Nørgård, BM [1,2], Kjeldsen, J [3,5]

Affiliates

[1]Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense C, Denmark. [2]Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark. [3]Department of Medical Gastroenterology S, Odense University Hospital, 5000 Odense C, Denmark. [4]Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. [5]Research Unit of Medical Gastroenterology, Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.

Abstract

Background
Medical therapy is the cornerstone in the management of inflammatory bowel disease (IBD). No studies provide a current overview in treatment pattern after introduction of newer biologic treatments.
This epidemiological study aims to describe the patterns of treatment of ulcerative colitis (UC) and Crohn’s disease (CD) in the first year following diagnosis using data from national Danish health registries.
Methods
Through the Danish National Patient Registry all patients with newly diagnosed UC or CD in Denmark from January 1st2015 to December 31st2018 were identified.
Stratified analyses for UC and CD were performed. Medication was grouped reflecting severity of disease activity in 5-ASA, azathioprine (AZA), corticosteroids (CS), and biologic therapy (BIO). Grouping of medications is shown in Table 1.
Results
3,906 patients with UC and 2,423 patients with CD were included in the study.
UC at diagnosis: 2,855(73.1%) patients had 5-ASA around time of diagnosis either alone or in combination with BIO and/or CS. 942 individuals (25.1%) had CS(no BIO) and 286(7.3%) had BIO.
UC 1 year after diagnosis (Table2):About half of patients had 5-ASA (n=2,206(56.5%)) either alone or in combination with AZA, BIO and/or CS. In the BIO group 40.9% remained on BIO treatment. In the group using CS at diagnosis 15.7% used CS 1 year after diagnosis.
CD at diagnosis: 1,009 individuals (41.6%) had CS, 239 individuals (9.9%) had BIO, and 1,175 individuals (48.5%) did not use either CS or BIO.
CD 1 year after diagnosis (Table3):161(67.4%) patients from the BIO group still had BIO around 1 year after diagnosis. For individuals having CS at diagnosis 18.4% still had CS 1 year after diagnosis.
Conclusions
Few individuals that had CS at diagnosis had CS 1 year after diagnosis (UC:15.7%,CD:18.4%). Drug persistence was high in the BIO groups (UC:40.9%,CD:67.5%).