Search in the Abstract Database

Abstracts Search 2017

* = Presenting author

P383 Increasing treatment time on REMICADE® (infliximab) predicts subsequent long-term retention in stable infliximab inflammatory bowel disease patients in Canada

Marshall J.K.*1,2, Marrache A.M.3, Ewara E.4

1McMaster University Medical Center, Department of Gastroenterology, Hamilton, Canada 2Farncombe Family Digestive Health Research Institute, Hamilton, Canada 3Janssen Inc., Medical Affairs, Toronto, Canada 4Janssen Inc., Government Affairs and Market Access, Toronto, Canada

Background

A high percentage of patients treated with anti-TNF agents discontinue therapy. The objective of this analysis was to determine the long-term retention patterns of stable Canadian IBD patients treated with REMICADE® (infliximab [IFX]).

Methods

Using IMS Brogan's™ database of Canadian private and public insurance claims data, our analysis included IBD patients with: (1) first IFX claim between Jan 2008-May 2015; (2) no IFX claims 12 months prior to the initial claim; (3) ≥1 claim for any drug 12 months after the initial IFX claim; and (4) ≥1 claim for any non-IFX drug 4 months after May 2015. Retention was measured at 12-month intervals and unadjusted odds ratios were determined. Within-group analyses compared 12 month retention by number of years on IFX and considered cohorts of patients according to age group, gender and previous biologic experience.

Results

4,360 patients had ≥2 years of claims history and had been on IFX for ≥1 year. Within-group comparisons showed that the probability of being retained on IFX in subsequent 12 month periods increased with cumulative prior time on IFX. Patients on IFX for 2 to 5 years showed significantly higher retention in the subsequent 12 months compared to patients on IFX for only 1 year (p<0.05). Similar trends were observed across both genders, in patients 19–64 years of age, and for patients who were biologic-naïve.

Table 1. Patients retained 12 months later (%)

# Years on IFXIBD patientsMaleFemaleBio-naiveBio-exposed0–18 years19–64 years65+ years
N=4,360N=2,055N=2,288N=4,147N=221N=419N=3,561N=361
180.382.178.580.576.981.479.883.9
284.484.784.084.286.387.783.986.8
386.987.586.487.089.887.886.392.1
488.089.986.088.270.087.087.990.3
590.990.991.090.710076.992.588.0

Table 2. Odds ratio of being retained (p<0.05 unless noted otherwise)

Year vs yearIBD patientsMaleFemaleBio-naiveBio-exposed0–18 years19–64 years65+ years
N=4,360N=2,055N=2,288N=4,147N=221N=419N=3,561N=361
2 vs 11.31.2 (p=0.06)1.41.31.91.61.21.3 (p=0.36)
3 vs 11.61.51.71.62.71.6 (p=0.08)1.42.2
4 vs 11.81.91.71.80.7 (p=0.40)1.5 (p=0.26)1.71.8 (p=0.12)
5 vs 12.52.22.82.4N/A0.8 (p=0.57)2.81.4 (p=0.46)

Conclusion

Real world patients treated with IFX have excellent long-term retention. Previous duration of IFX treatment appears to predict better future retention, becoming statistically significant after 2 years. The results were robust and consistent amongst various subgroups of stable Canadian IBD patients.