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P573. Changes in resource utilisation in patients with Crohn's disease treated with adalimumab in routine clinical practice

C. Saro1, D. Ceballos2, F. Muñoz3, C. De la Coba1, M.D. Aguilar4, P. Lazaro4, 1Cabueñes Hospital, Spain, 2Dr. Negrín Hospital, Spain, 3Hospital de León, León, Spain, 4TAISS, Madrid, Spain

Background

Crohn's disease (CD) is a chronic and recurrent disease with numerous complications, producing a high consumption of health and social resources. It could be suggested that because of the efficacy of biologic treatments, their use could reduce the resource utilisation. The aim of the study is to compare the resource utilisation during the 12 months prior to treatment with adalimumab (ADA) in the EC with respect to the following 12 months in routine clinical practice.

Methods

Multicentre prospective observational cohort study with follow up of 12 months. Inclusion criteria: Patients with CD naïve to biologics, in which the doctor prescribes ADA according to routine clinical practice. In the medical visit at the beginning of the biologic treatment, direct (hospitalisations, medical visits, surgeries, diagnostic tests and medications) and indirect resource (Work Productivity and Activity Impairment [WPAI]) consumption during year previous (Y-1) to the ADA treatment were retrospectively collected. Such data were again recorded prospectively in 5 visits during the following year (Y-2). Y-1 and Y-2 data were compared. For hypothesis testing, parametric or nonparametric tests were used according to the data distribution.

Results

126 patients (50.8% men; age 39.1±13.8 years; 60.3% active workers) from 33 centres were included. The respective means for Y-1 vs. Y-2 of the following resources per patient were: 12.4 vs. 7.4 (p < 0.001) medical visits, 1.2 vs. 0.7 (p < 0.001) emergency room visits, 4.4 vs. 3.7 (NS) hospitalisation days, 0.0 vs. 0.1 (NS) days in intensive care units, 0.9 vs. 1.5 (NS) days in day hospital, 5.3 vs. 2.4 (p < 0.001) diagnostic tests. The number of surgeries decreased from 33 during Y-1 to 29 during Y-2. The consumption of non-biologic drugs during Y-2 decreased with respect to Y-1 (p < 0.001). The mean of work hours lost by the EC decreased from 12.9 to 4.0 (p = 0.004) and lost by other causes from 3.7 to 0.9 (NS). The work productivity impact (scale 0–10) decreased from 3.3 to 1.6 (p = 0.006) and the impact in non-work activities (scale 0–10) decreased from 5.0 to 2.3 (p < 0.001).

Conclusion

In clinical practice, the treatment with ADA decreases the direct and indirect resources utilisation comparing the 12 months before the treatment with the following 12 months.