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Steroid and antibiotic prescribing rates in UK patients with ulcerative colitis on vedolizumab vs anti-TNF
Abstract
Introduction This study evaluated corticosteroid and antibiotic prescribing during the first 12 months of first-line biologic therapy in patients with ulcerative colitis (UC) initiated on vedolizumab (VDZ) compared with patients initiated on anti-tumour necrosis factor-α (anti-TNF) agents.
Methods A multicentre, retrospective observational study was conducted in six United Kingdom secondary care centres. Eligible consenting patients were aged ≥18 years at initiation, without primary fistulising disease or acute severe disease. Patients were matched for age, gender, Montreal classification of disease extent and steroid use at initiation.
Results The study included 56 patients initiated on VDZ and 56 patients initiated on anti-TNF (table 1). During the overall 12 month post-initiation observation period, patients initiated on VDZ and anti-TNF were prescribed a median of 1.0 (interquartile range [IQR] 0.0–4.8) and 2.0 (IQR 0.0–7.8; Mann-Whitney U test P=0.16) courses of corticosteroids, respectively. During the post-initiation maintenance period (week 14 to month 12), 37% (95% confidence interval [CI] 24%–49%; n=52) of patients initiated on VDZ and 57% (95%CI 44%–70%; n=53; χ2 P=0.039) of patients initiated on anti-TNF received at least one course of corticosteroids. During the overall 12 month post-initiation observation period, patients initiated on VDZ and anti-TNF were prescribed a median of 0 (range 0–4) and 0 (range 0–2; Mann-Whitney U test P=0.42) courses of antibiotics, respectively. During the post-initiation maintenance period, 11% (95%CI 3%–19%; n=56) of patients initiated on VDZ and 16% (95%CI 6%–26%; n=56; χ2 P=0.41) of patients initiated on anti-TNF received at least one course of antibiotics.
Conclusions During the post-initiation maintenance period of first-line biologic therapy in patients with UC, patients initiated on VDZ were significantly less likely to be prescribed corticosteroids than matched patients initiated on anti-TNF agents. Numerically less patients on VDZ received antibiotics, however this did not reach significance.
Authors
G Parkes, A Akbar, I Beales, M Buckley, T Creed, S Din, N Plevris, N Heggs, S Meadowcroft, M Wallington, A Fraser
Journal
Gut
Therapeutic Area
Gastroenterology
Center of Excellence
Real-world Evidence & Data Analytics
Year
2021
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