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Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis

BACKGROUND: We compared real-world healthcare resource utilization (HRU), Crohn’s disease (CD)-related complications, and time to systemic corticosteroid discontinuation between patients with CD treated with adalimumab versus vedolizumab as initial biologic. METHODS: Biologic-naïve adults with CD an...

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Autores principales: Ungaro, Ryan C, Griffith, Jenny, Garcia-Horton, Viviana, Wang, Aolin, Cross, Raymond K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434638/
https://www.ncbi.nlm.nih.gov/pubmed/36061451
http://dx.doi.org/10.1093/crocol/otac029
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author Ungaro, Ryan C
Griffith, Jenny
Garcia-Horton, Viviana
Wang, Aolin
Cross, Raymond K
author_facet Ungaro, Ryan C
Griffith, Jenny
Garcia-Horton, Viviana
Wang, Aolin
Cross, Raymond K
author_sort Ungaro, Ryan C
collection PubMed
description BACKGROUND: We compared real-world healthcare resource utilization (HRU), Crohn’s disease (CD)-related complications, and time to systemic corticosteroid discontinuation between patients with CD treated with adalimumab versus vedolizumab as initial biologic. METHODS: Biologic-naïve adults with CD and ≥2 claims between 05/20/2014 and 09/30/2019 for adalimumab or vedolizumab were identified in the IBM MarketScan research database. Patient characteristics were assessed during the 6-month baseline period before biologic initiation (index date). Adalimumab- and vedolizumab-treated patients were propensity score-matched 1:1 on demographics, disease characteristics, and comorbidities with ≥10% prevalence that differed significantly between groups. Categorical, continuous, and time-to-event outcomes between groups during the 12-month follow-up on/after index were compared with chi-square tests, Wilcoxon rank-sum tests, and Kaplan–Meier analyses, respectively. RESULTS: Adalimumab- and vedolizumab-treated patients were matched (n = 461 per group) and baseline characteristics balanced. Significantly fewer adalimumab- versus vedolizumab-treated patients had a CD-related emergency room visit (12-month proportion: 14.5% vs 21.0%; log-rank P < 0.01) or inpatient admission (14.9% vs 20.2%; log-rank P < 0.05). Rates of CD-related surgeries were similar (9.3% vs 11.5%; log-rank P = 0.282). Among patients without internal/perianal abscess or fistula or intestinal stricture at baseline (N(ADA) = 360, N(VDZ) = 364), numerically but not significantly fewer adalimumab- versus vedolizumab-treated patients had CD-related complications at 12 months (18.3% vs 22.3%; P = 0.171). Among patients with corticosteroid use at index (N(ADA) = 143, N(VDZ) = 139), significantly more adalimumab- versus vedolizumab-treated patients discontinued corticosteroids (12-month proportion: 90.2% vs 76.3%; log-rank P < 0.001). CONCLUSIONS: Patients with CD treated with adalimumab as their first biologic experienced significantly lower CD-related HRU and were more likely to discontinue corticosteroids compared to vedolizumab-treated patients.
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spelling pubmed-94346382022-09-01 Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis Ungaro, Ryan C Griffith, Jenny Garcia-Horton, Viviana Wang, Aolin Cross, Raymond K Crohns Colitis 360 Observations and Research BACKGROUND: We compared real-world healthcare resource utilization (HRU), Crohn’s disease (CD)-related complications, and time to systemic corticosteroid discontinuation between patients with CD treated with adalimumab versus vedolizumab as initial biologic. METHODS: Biologic-naïve adults with CD and ≥2 claims between 05/20/2014 and 09/30/2019 for adalimumab or vedolizumab were identified in the IBM MarketScan research database. Patient characteristics were assessed during the 6-month baseline period before biologic initiation (index date). Adalimumab- and vedolizumab-treated patients were propensity score-matched 1:1 on demographics, disease characteristics, and comorbidities with ≥10% prevalence that differed significantly between groups. Categorical, continuous, and time-to-event outcomes between groups during the 12-month follow-up on/after index were compared with chi-square tests, Wilcoxon rank-sum tests, and Kaplan–Meier analyses, respectively. RESULTS: Adalimumab- and vedolizumab-treated patients were matched (n = 461 per group) and baseline characteristics balanced. Significantly fewer adalimumab- versus vedolizumab-treated patients had a CD-related emergency room visit (12-month proportion: 14.5% vs 21.0%; log-rank P < 0.01) or inpatient admission (14.9% vs 20.2%; log-rank P < 0.05). Rates of CD-related surgeries were similar (9.3% vs 11.5%; log-rank P = 0.282). Among patients without internal/perianal abscess or fistula or intestinal stricture at baseline (N(ADA) = 360, N(VDZ) = 364), numerically but not significantly fewer adalimumab- versus vedolizumab-treated patients had CD-related complications at 12 months (18.3% vs 22.3%; P = 0.171). Among patients with corticosteroid use at index (N(ADA) = 143, N(VDZ) = 139), significantly more adalimumab- versus vedolizumab-treated patients discontinued corticosteroids (12-month proportion: 90.2% vs 76.3%; log-rank P < 0.001). CONCLUSIONS: Patients with CD treated with adalimumab as their first biologic experienced significantly lower CD-related HRU and were more likely to discontinue corticosteroids compared to vedolizumab-treated patients. Oxford University Press 2022-08-04 /pmc/articles/PMC9434638/ /pubmed/36061451 http://dx.doi.org/10.1093/crocol/otac029 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Observations and Research
Ungaro, Ryan C
Griffith, Jenny
Garcia-Horton, Viviana
Wang, Aolin
Cross, Raymond K
Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis
title Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis
title_full Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis
title_fullStr Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis
title_full_unstemmed Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis
title_short Adalimumab Is Associated With Lower Healthcare Resource and Steroid Use Versus Vedolizumab in Biologic-Naive Crohn’s Disease: A Retrospective Claims Database Analysis
title_sort adalimumab is associated with lower healthcare resource and steroid use versus vedolizumab in biologic-naive crohn’s disease: a retrospective claims database analysis
topic Observations and Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434638/
https://www.ncbi.nlm.nih.gov/pubmed/36061451
http://dx.doi.org/10.1093/crocol/otac029
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