Medication use among patients with Crohn's disease or ulcerative colitis before and after the initiation of advanced therapy

Theresa Hunter; April N Naegeli; Chi Nguyen; Mingyang Shan; Joseph L Smith; Hiangkiat Tan; Klaus Gottlieb; Keith Isenberg

doi:10.1186/s12876-022-02584-4

Medication use among patients with Crohn's disease or ulcerative colitis before and after the initiation of advanced therapy

BMC Gastroenterol. 2022 Nov 19;22(1):474. doi: 10.1186/s12876-022-02584-4.

Authors

Theresa Hunter¹, April N Naegeli², Chi Nguyen³, Mingyang Shan², Joseph L Smith³, Hiangkiat Tan³, Klaus Gottlieb², Keith Isenberg⁴

Affiliations

¹ Eli Lilly and Company, 893 S. Delaware Street, Indianapolis, IN, 46225, USA. hunter_theresa_marie@lilly.com.
² Eli Lilly and Company, 893 S. Delaware Street, Indianapolis, IN, 46225, USA.
³ HealthCore, Inc., Wilmington, USA.
⁴ Anthem, Inc., Indianapolis, USA.

Abstract

Background: Although various treatments help reduce abdominal pain, real-world pain medication utilization among patients with Crohn's disease (CD) or ulcerative colitis (UC) receiving advanced therapies is poorly understood. The aim is to understand the utilization of pain medication 12 months before and after the initiation of advanced therapies among patients with newly diagnosed CD or UC.

Methods: This retrospective, observational cohort study used administrative medical and pharmacy claims data of patients with CD or UC from HealthCore Integrated Research Database (HIRD^®). The data from patients with use of pain medication over 12 months follow-up (after the initiation date of advanced therapies) were collected and analyzed. Differences in the use of pain medication 12 months before and after the initiation of advanced therapies were assessed using McNemar's and Wilcoxon signed-rank test.

Results: Prior to initiating advanced therapies, 23.1% of patients with CD (N = 540) received nonsteroidal anti-inflammatory drugs (NSAIDs), 78.1% glucocorticoids, 49.4% opioids, and 29.3% neuromodulators; similarly, 20.9% of patients with UC (N = 373) received NSAIDs, 91.4% glucocorticoids, 40.8% opioids, and 29.5% neuromodulators. After receiving advanced therapies for 12 months, patients reported a reduction in the use of steroids (78.1% vs. 58.9%, P < 0.001 in CD; 91.4% vs. 74.3%, P < 0.001 in UC), opioids (49.4% vs. 41.5%, P = 0.004 in CD; 40.8% vs. 36.5%, P = 0.194 in UC), and NSAIDs (23.1% vs. 15.0%, P < 0.001 in CD; 20.9% vs. 15.8%, P = 0.035 in UC), while the use of neuromodulators significantly increased (29.3% vs. 33.7%, P = 0.007 in CD; 29.5% vs. 35.7%; P = 0.006 in UC).

Conclusions: The use of pain medications such as NSAIDs, glucocorticoids, opioids, and neuromodulators was common among patients with CD or UC. These results highlight that patients with CD or UC continued to receive pain medications even after initiating advanced therapies.

Keywords: Abdominal pain; Advanced therapies; Crohn’s disease; Ulcerative colitis.

Publication types

Observational Study

MeSH terms

Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Colitis, Ulcerative* / drug therapy
Crohn Disease* / complications
Crohn Disease* / drug therapy
Glucocorticoids / therapeutic use
Humans
Pain
Retrospective Studies

Substances

Glucocorticoids
Anti-Inflammatory Agents, Non-Steroidal