Real-World Biologic Prescribing Patterns and Reasons for Discontinuation in Patients with UC and CD
Author(s)
Abbey Stackpole, Pharm.D, David Iwanyckyj, BS, Fernando Otalora, MS, John Perez, MS, MBA, Melanie Jardim, PhD.
Amplity, Langhorne, PA, USA.
Amplity, Langhorne, PA, USA.
Presentation Documents
OBJECTIVES: Biologic therapies for patients with ulcerative colitis (UC) and Crohn’s disease (CD) play a vital role in the treatment paradigm. Selection of first-line biologic therapy and the decision to switch to an alternative biologic are typically based on an individualized approach. This study aimed to assess real-world prescribing patterns of biologics and explore factors driving therapy changes.
METHODS: Natural language processing (NLP) was used to search and analyze the Amplity AnswerY™ database and platform, composed of US-based transcribed physician notes, for patients diagnosed with UC or CD. Patients were followed through subsequent lines of biologic therapy, and trends in prescribing habits were gathered from all-time records, records before 2023 (≤2022), and records from 2023 onward (≥2023). Reasons for discontinuation were documented between lines of therapy.
RESULTS: AnswerY identified 8,737 patients with UC and 20,185 patients with CD treated with a biologic therapy. All-time, the most common first-line biologics were adalimumab (41.21% UC, 39.7% CD) and infliximab (36% UC, 32.6% CD), followed by vedolizumab (15.6% UC, 12.2% CD). The average time to discontinuation of first-line infliximab and adalimumab in patients with UC and CD was 8.5 months and 8 months, respectively. The most frequently reported reasons for discontinuing first-line therapy were adverse events (26.17% UC, 24.75% CD) and efficacy (18.07% UC, 14% CD). Second-line therapy for patients with UC included infliximab (33.3%), vedolizumab (30.4%), and adalimumab (23.5%). For patients with CD, it was distributed among infliximab (28.5%), adalimumab (26%), ustekinumab (19.8%), and vedolizumab (19.67%). These trends were similar for ≤2022 and ≥2023.
CONCLUSIONS: Analysis of AnswerY database shows adalimumab and infliximab are the most utilized first-line biologics, with a wider range of agents used in second-line therapy. Using artificial intelligence and NLP to review patient-provider transcripts, AnswerY identified reasons for treatment discontinuation and average time on therapy before switching.
METHODS: Natural language processing (NLP) was used to search and analyze the Amplity AnswerY™ database and platform, composed of US-based transcribed physician notes, for patients diagnosed with UC or CD. Patients were followed through subsequent lines of biologic therapy, and trends in prescribing habits were gathered from all-time records, records before 2023 (≤2022), and records from 2023 onward (≥2023). Reasons for discontinuation were documented between lines of therapy.
RESULTS: AnswerY identified 8,737 patients with UC and 20,185 patients with CD treated with a biologic therapy. All-time, the most common first-line biologics were adalimumab (41.21% UC, 39.7% CD) and infliximab (36% UC, 32.6% CD), followed by vedolizumab (15.6% UC, 12.2% CD). The average time to discontinuation of first-line infliximab and adalimumab in patients with UC and CD was 8.5 months and 8 months, respectively. The most frequently reported reasons for discontinuing first-line therapy were adverse events (26.17% UC, 24.75% CD) and efficacy (18.07% UC, 14% CD). Second-line therapy for patients with UC included infliximab (33.3%), vedolizumab (30.4%), and adalimumab (23.5%). For patients with CD, it was distributed among infliximab (28.5%), adalimumab (26%), ustekinumab (19.8%), and vedolizumab (19.67%). These trends were similar for ≤2022 and ≥2023.
CONCLUSIONS: Analysis of AnswerY database shows adalimumab and infliximab are the most utilized first-line biologics, with a wider range of agents used in second-line therapy. Using artificial intelligence and NLP to review patient-provider transcripts, AnswerY identified reasons for treatment discontinuation and average time on therapy before switching.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD103
Topic
Real World Data & Information Systems
Disease
SDC: Gastrointestinal Disorders, STA: Biologics & Biosimilars