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HEALTHCARE RESOURCE UTILIZATION AND TREATMENT USAGE AMONG FLARING AND NON-FLARING PATIENTS WITH ULCERATIVE COLITIS – A REAL-WORLD GLOBAL STUDY

Axel Dignass 1, Isabel Redondo 2, Petra Streit 3, Susanne Hartz 4, Hannah Knight 5, Sophie Barlow 5, niamh harvey 5, Theresa Hunter Gibble 6

Affiliations

1 Agaplesion Markus Krankenhaus, Frankfurt/ Main, Germany

2 Eli Lilly and Company, Lisbon, Portugal

3 Eli Lilly and Company, Vernier, Switzerland

4 Eli Lilly and Company, Bracknell, United Kingdom

5 Adelphi Real World, Bollington, United Kingdom

6 Eli Lilly and Company, Indianapolis, United States

Summary

AI Generated

In a six-country survey of 2,019 ulcerative colitis patients with moderate-severe disease history, nearly half experienced a flare in the prior 12 months and demonstrated substantially higher healthcare resource use and treatment intensification compared to non-flaring patients.

Patients who flared in the past 12 months (47.9% of the cohort) had significantly more consultations (7.2 vs 5.3), hospitalizations (0.4 vs 0.1), and diagnostic procedures than non-flaring patients (all p<0.01).
Flaring patients were nearly three times more likely to have received corticosteroids in the past year (39.4% vs 13.9%, p<0.01).
Among patients on targeted therapies for at least 12 months, 25.7% of flaring patients required dose escalation compared to 11.7% of non-flaring patients (p<0.01).
Flaring patients had shorter disease duration (4.7 vs 5.3 years, p=0.05) and greater disease extension (p<0.01) than non-flaring patients, though age and sex were similar.
Data were collected via gastroenterologist survey across France, Germany, Italy, Spain, the United Kingdom, and the United States from January 2020 to March 2021; the study was supported by Eli Lilly and Company.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Despite increasing treatment opportunities for ulcerative colitis (UC), patients often suffer acute periods of increased disease severity. Since little is known regarding how healthcare resource utilization (HCRU) and drug dosing differ between flaring and non-flaring patients in a real-world clinical setting, we aimed to assess these differences.

Aims & Methods

Data were extracted from the Adelphi UC Disease Specific Programme, a point-in-time survey of gastroenterologists and patients conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States from January 2020 - March 2021. Gastroenterologists provided clinical characteristics, treatment history and HCRU for their next 5-7 consulting UC patients with a history of moderate-severe disease. Patients were categorized based on whether they had experienced a flare in the last 12 months, and compared using Fisher’s exact, t-test and Mann-Whitney tests. Two subgroups were analysed separately to explore drug dosing patterns for flaring and non-flaring patients; those on targeted therapies (TT; biologics, Janus kinase inhibitors) who had been receiving their therapy for ≥12 months and those who were currently receiving corticosteroids.

Results

This study included 2,019 patients; 968 (47.9%) were reported by their gastroenterologist to have flared in the last 12 months, while 1,051 (52.1%) had no flares. While age and sex were similar across the patient subgroups, flaring patients had a shorter disease duration (p=0.05) and greater disease extension (p<0.01) than non-flaring patients (Table 1). Differences were seen across all HCRU measures with a greater number of consultations (7.2 vs 5.3), hospitalizations (0.4 vs 0.1), biopsies, endoscopies, stool and blood tests in the last 12 months for flaring patients compared to non-flaring patients (all p<0.01). A higher proportion of flaring patients had received corticosteroids in the last 12 months compared to non-flaring patients (39.4% vs 13.9%, p<0.01), and among those currently receiving corticosteroids, 9.9% of flaring patients had their corticosteroid dose escalated vs 5.6% of non-flaring patients (p=0.28). Of those patients receiving their current TT for ≥12 months, 25.7% of flaring patients had their TT dose escalated compared to 11.7% of non-flaring patients (p<0.01).

Table 1. Gastroenterologist-reported patient demographics, clinical characteristics, healthcare resource utilization, and treatment usage

	Not flared in the last 12 months (n=1,051)	Flared in the last 12 months (n=968)	p-value
Age, mean (SD)	40.4 (14.4)	40.1 (14.3)	0.63
Sex, Male, n (%)	576 (54.8)	511 (52.8)	0.37
Ethnicity, White/ Caucasian, n (%)	939 (89.3)	826 (85.3)	<0.01
Disease duration, years Mean (SD)	n=956 5.3 (6.2)	n=924 4.7 (5.6)	0.05
Total number of consultations in the last 12 months Mean (SD)	n=740 5.3 (4.6)	n=767 7.2 (6.2)	<0.01
Number of hospitalizations in the last 12 months Mean (SD)	n=947 0.1 (0.9)	n=892 0.4 (0.8)	<0.01
Has the patient received corticosteroids in the last 12 months? Yes, n (%)	146 (13.9)	381 (39.4)	<0.01
During the course of the current regimen, has the corticosteroid dose changed? Escalated, n (%) Not escalated, n (%)	n=90 5 (5.6) 85 (94.4)	n=274 27 (9.9) 247 (90.2)	0.28
During the maintenance phase, has the dose of targeted therapy changed? Escalated, n (%) Not escalated, n (%)	n=436 51 (11.7) 385 (88.3)	n=171 44 (25.7) 127 (74.3)	<0.01

Conclusion

Almost half of patients with UC in our cohort had experienced a flare within the last 12 months. These patients had greater HCRU, increased corticosteroid use, and those on TT were more likely to receive escalated drug doses, highlighting the need for additional treatment options to target disease control, entailing the potential for a reduced burden of flares on UC patients and healthcare systems.

Disclosure

This study was supported by Eli Lilly and Company.

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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