Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States
Abstract Background The purpose of this analysis was to assess the frequency of inadequate response over 1 year from advanced therapy initiation among patients with Crohn’s disease (CD) or ulcerative colitis (UC) in the United States using a claims-based algorithm. Factors associated with inadequate...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-023-02675-w |
| _version_ | 1797864567117709312 |
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| author | Theresa Hunter Gibble April N. Naegeli Michael Grabner Keith Isenberg Mingyang Shan Chia-Chen Teng Jeffrey R. Curtis |
| author_facet | Theresa Hunter Gibble April N. Naegeli Michael Grabner Keith Isenberg Mingyang Shan Chia-Chen Teng Jeffrey R. Curtis |
| author_sort | Theresa Hunter Gibble |
| collection | DOAJ |
| description | Abstract Background The purpose of this analysis was to assess the frequency of inadequate response over 1 year from advanced therapy initiation among patients with Crohn’s disease (CD) or ulcerative colitis (UC) in the United States using a claims-based algorithm. Factors associated with inadequate response were also analyzed. Methods This study utilized claims data of adult patients from the HealthCore Integrated Research Database (HIRD®) from January 01, 2016 to August 31, 2019. Advanced therapies used in this study were tumor necrosis factor inhibitors (TNFi) and non-TNFi biologics. Inadequate response to an advanced therapy was identified using a claims-based algorithm. The inadequate response criteria included adherence, switching to/added a new treatment, addition of a new conventional synthetic immunomodulator or conventional disease-modifying drugs, increase in dose/frequency of advanced therapy initiation, and use of a new pain medication, or surgery. Factors influencing inadequate responders were assessed using multivariable logistic regression. Results A total of 2437 patients with CD and 1692 patients with UC were included in this analysis. In patients with CD (mean age: 41 years; female: 53%), 81% had initiated TNFi, and 62% had inadequate response. In patients with UC (mean age: 42 years; female: 48%), 78% had initiated a TNFi, and 63% had an inadequate response. In both patients with CD and UC, inadequate response was associated with low adherence (CD: 41%; UC: 42%). Inadequate responders were more likely to be prescribed a TNFi (for CD: odds ratio [OR] = 1.94; p < 0.001; for UC: OR = 2.76; p < 0.0001). Conclusion More than 60% of patients with CD or UC had an inadequate response to their index advanced therapy within 1 year after initiation, mostly driven by low adherence. This modified claims-based algorithm for CD and UC appears useful to classify inadequate responders in health plan claims data. |
| first_indexed | 2024-04-09T22:53:58Z |
| format | Article |
| id | doaj.art-7edb26816d3040a9b02d3009dc35753e |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-09T22:53:58Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-7edb26816d3040a9b02d3009dc35753e2023-03-22T11:22:53ZengBMCBMC Gastroenterology1471-230X2023-03-0123111010.1186/s12876-023-02675-wIdentification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United StatesTheresa Hunter Gibble0April N. Naegeli1Michael Grabner2Keith Isenberg3Mingyang Shan4Chia-Chen Teng5Jeffrey R. Curtis6Eli Lilly and CompanyEli Lilly and CompanyHealthCore, Inc.Anthem, Inc.Eli Lilly and CompanyHealthCore, Inc.University of Alabama at BirminghamAbstract Background The purpose of this analysis was to assess the frequency of inadequate response over 1 year from advanced therapy initiation among patients with Crohn’s disease (CD) or ulcerative colitis (UC) in the United States using a claims-based algorithm. Factors associated with inadequate response were also analyzed. Methods This study utilized claims data of adult patients from the HealthCore Integrated Research Database (HIRD®) from January 01, 2016 to August 31, 2019. Advanced therapies used in this study were tumor necrosis factor inhibitors (TNFi) and non-TNFi biologics. Inadequate response to an advanced therapy was identified using a claims-based algorithm. The inadequate response criteria included adherence, switching to/added a new treatment, addition of a new conventional synthetic immunomodulator or conventional disease-modifying drugs, increase in dose/frequency of advanced therapy initiation, and use of a new pain medication, or surgery. Factors influencing inadequate responders were assessed using multivariable logistic regression. Results A total of 2437 patients with CD and 1692 patients with UC were included in this analysis. In patients with CD (mean age: 41 years; female: 53%), 81% had initiated TNFi, and 62% had inadequate response. In patients with UC (mean age: 42 years; female: 48%), 78% had initiated a TNFi, and 63% had an inadequate response. In both patients with CD and UC, inadequate response was associated with low adherence (CD: 41%; UC: 42%). Inadequate responders were more likely to be prescribed a TNFi (for CD: odds ratio [OR] = 1.94; p < 0.001; for UC: OR = 2.76; p < 0.0001). Conclusion More than 60% of patients with CD or UC had an inadequate response to their index advanced therapy within 1 year after initiation, mostly driven by low adherence. This modified claims-based algorithm for CD and UC appears useful to classify inadequate responders in health plan claims data.https://doi.org/10.1186/s12876-023-02675-wAdvanced therapyBiologicsClaims-based algorithmCrohn’s diseaseHealthCore Integrated Research Database®Inadequate response |
| spellingShingle | Theresa Hunter Gibble April N. Naegeli Michael Grabner Keith Isenberg Mingyang Shan Chia-Chen Teng Jeffrey R. Curtis Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States BMC Gastroenterology Advanced therapy Biologics Claims-based algorithm Crohn’s disease HealthCore Integrated Research Database® Inadequate response |
| title | Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States |
| title_full | Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States |
| title_fullStr | Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States |
| title_full_unstemmed | Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States |
| title_short | Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States |
| title_sort | identification of inadequate responders to advanced therapy among commercially insured adult patients with crohn s disease and ulcerative colitis in the united states |
| topic | Advanced therapy Biologics Claims-based algorithm Crohn’s disease HealthCore Integrated Research Database® Inadequate response |
| url | https://doi.org/10.1186/s12876-023-02675-w |
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