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UC patients frequently switched immunomodulators, experienced relapse
Immunomodulator treatment among patients with ulcerative colitis appeared to result in frequent medication switches, as well as high rates of subsequent complications and relapse, according to recent findings.
Researchers evaluated claims data for 2,136 patients (mean age, 46 years; 54% women) with ulcerative colitis (UC). The patients identified for analysis had at least two UC diagnosis claims between January 2005 and July 2010, or at least one immunomodulator (IM) claim. The initial IM claim was established as the index date.
The researchers chronicled all updates and changes to the index IM therapy during follow-up, as well as complications and disease recurrences. Azathioprine was the most common index IM (46% of patients), followed by 6-mercaptopurine (28%), methotrexate (13%) and cyclosporine (13%).
Data showed that 21% of patients switched from the index IM to another class of medication during the study period. Forty-eight percent of patients who switched IM received 5-ASAs, 21% switched to oral corticosteroids, and 17% switched to biologics. In 25% of cases, patients required a second agent to complement a treatment regimen, with 5-ASA ranking as the most frequently added agent (72%).
Complications were seen in approximately 30% of patients, with blood disorders (11%) and arthralgia (10%) occurring most frequently. Seventy-three percent of patients relapsed, which occurred most often while patients were taking their index IM. High use of corticosteroids (56%) most commonly indicated relapse.
“IM treatments in ulcerative colitis are not curative and carry increased risk of complications, sometimes leading to therapy changes, reduced treatment benefits, and eventual relapse,” the researchers wrote. “This assessment of IM treatments for UC demonstrated frequent changes to therapy and high downstream complication and relapse rates.”
Disclosure: See the study for a full list of relevant financial disclosures.