P405 5-ASA prescription trends over time in inflammatory bowel disease 1996 to 2015–A UK population-based study
V. Jairath1,2*, S. Hokkanen3, L. Guizzetti2, N. Boxall3, S. Campbell-Hill4, H. Patel4
1Western University, Department of Medicine, London, Ontario, Canada, 2Robarts Clinical Trials Inc., London, Ontario, Canada, 3IQVIA, London, UK, 4Takeda International–UK Branch, London, UK
5-Aminosalicylates (5-ASA) are commonly prescribed for inflammatory bowel disease (IBD). Whilst they are effective in mild–moderate ulcerative colitis (UC), evidence for their benefit in Crohn’s disease (CD) is controversial. Few data are available on the evolution of 5-ASA prescriptions over time, from a population level.
5-ASA prescription trends in prevalent IBD patients in The Health Improvement Network (THIN) UK primary care database were evaluated retrospectively across five 4-year periods (era 1–5) between 1996 and 2015. The proportion of patients prescribed 5-ASA at any time of their disease, and within 1 year of IBD diagnosis was stratified by IBD type, 5-ASA type and age group (015–<18, ≥18–<65, ≥5, years). Prolonged use was defined as continuous use for ≥ye months. Chi-squared test for trend was used to evaluate differences in prescription trends. Trends were qualitatively assessed relative to the publication of new evidence and guidelines.
Prevalence of 5-ASA prescriptions over time and total number of patients by each era are shown in Figure 1.
Demographic characteristics were similar over time: 48–51% of UC and 56–58% CD patients were female; the range of mean age of UC patients was 50–56 years and 46–50 years in CD. Current smoking status declined in UC (12–8%) and CD (32–20%) from era 1 to 5. For UC, 5-ASA prescriptions declined from 83% in era 1 to 71% in era 5 (
5-ASA remains a highly used treatment for UC and CD in the UK. Almost one-third of IBD patients had a prolonged use of 5-ASA. Despite lack of strong evidence for their benefit in CD, half of patients are still prescribed 5-ASA for CD, indicating a disparity between evidence base and clinical prescribing practice.