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P425 Comparison of therapeutic choices in biologic experienced Crohn’s disease and ulcerative colitis patients in Europe: discontinuation rates because of disease improvements

A. Franceschetti*1, A. Baskett2, H. McKenzie2

1Ipsos healthcare, London, United Kingdom, 2Ipsos Healthcare, London, United Kingdom

Background

We assessed the reasons for Crohn’s disease (CD) and ulcerative colitis (UC) patients to switch/discontinue their most recent biologic therapy in 5 European countries (EU5) (the United Kingdom, Germany, France, Italy, and Spain).

Methods

A medical chart review study of IBD patients was conducted amongst gastroenterologists in hospitals and private practices to collect de-identified data on treatment patterns. Physicians were recruited from an online panel to be geographically representative in each country; each physician was screened for duration of practice (3–30 years), patient volume (≥ 10 CD and ≥ 10 UC patients/month), and volume of patients seen currently on biologics (≥ 2 CD, ≥ 1 UC patients/month). Physicians abstracted the charts of the next 6 CD, and 4 UC biologic experienced patients in their centre/practice, and obtained and analysed results from patients who were currently receiving biologic therapy but had switched/discontinued in the past and results from patients who were no longer receiving any biologic therapy but had previously.

Results

In Q3 2015, 204 physicians abstracted 1 219 CD (UK 252, France 246, Germany 246, Italy 240, and Spain 235) and 812 UC (UK 168, France 164, Germany 164, Italy 160, and Spain 156) patient charts. Further, 1 106 (90.7%) CD and 726 (89.4%) UC patients were currently on a biologic therapy (mean age 37.9 in CD, 39.9 in UC), and 934 (76.6%) CD patients and 652 (80.3%) UC patients currently on their first biologic line were included. Of the total number of CD and UC patients abstracted, 285 (23.4%) CD and 160 (19.7%) UC patients had discontinued/switched from their most recent biologic. One of the top reasons for discontinuation of biologics across EU5 was ‘disease improved’ (19.6% CD and 24.4% UC discontinued patients), with higher percentages noted in UK UC patients (40.0% of 75 discontinued patients) and in CD German patients (34.7% of 49 discontinued patients). Of the 56 EU5 CD patients discontinued because of disease improvement, 76.8% were switched to conventional therapy without biologic co-management (corticosteroids, immunomodulators, or 5-ASAs), respectively, and of the 39 EU5 UC patients discontinued because of disease improvement, 94.9% were switched to conventional therapy without biologic co-management.

Conclusion

In EU5, a high proportion of IBD patients have discontinued their most recent biologic therapy because of disease improvement, potentially indicating a therapeutic strategy of physicians trying to alleviate biologic usage once desired efficacy is achieved.