TREATMENT PERSISTENCE OF FIRST-LINE ADVANCED THERAPIES IN OLDER ADULTS WITH ULCERATIVE COLITIS USING US CLAIMS DATA
Author(s)
Anita Afzali, MD, MPH, MHCM1, Zheng Si, MA2, Wenzhuo Zhao, MS2, Yen-Hua Chen, MA2, Jennifer Friderici, MS2, Kiraat Munshi, PhD3, Emily Gravlee, PharmD, PhD4, Ben Muller, PharmD3, Abigail M. Wojtowicz, PhD3, Joshua Brown, PharmD, PhD3;
1Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA, 2KMK Consulting Inc., Morris Plains, NJ, USA, 3Takeda Pharmaceuticals U.S.A., Inc., Cambridge, MA, USA, 4Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, USA
1Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, USA, 2KMK Consulting Inc., Morris Plains, NJ, USA, 3Takeda Pharmaceuticals U.S.A., Inc., Cambridge, MA, USA, 4Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, USA
OBJECTIVES: This retrospective cohort study evaluated the distribution and treatment persistence of first-line (1L) advanced therapies (ATs) in older adults with ulcerative colitis (UC).
METHODS: Claims data from adults with UC aged ≥ 65 years who initiated 1L AT between January 1, 2020 and March 31, 2024 were obtained from Optum’s de-identified Clinformatics® Data Mart Database. Baseline and follow-up were variable periods of continuous enrollment in medical and pharmacy benefits of ≥ 730 days before and ≥ 180 days after AT initiation, respectively. Baseline characteristics and AT distribution were summarized descriptively. Median time to discontinuation (time from AT initiation to AT end date, switching, end of continuous enrollment, or study end) and hazard ratios (HRs) were estimated by Kaplan-Meier analysis and univariable Cox proportional hazards models, respectively, with 95% confidence intervals (CIs).
RESULTS: Of 926 patients, 446 (48.2%) were male, the mean (standard deviation [SD]) age was 73.7 (5.4) years, and most (n = 850, 91.8%) had Medicare coverage. Mean (SD) Charlson Comorbidity Index and UC severity scores were 3.4 (2.9) and 11.2 (6.8), respectively. The most frequently prescribed 1L AT was vedolizumab (n = 445, 48.1%), followed by infliximab (n = 241, 26.0%), adalimumab (n = 111, 12.0%), ustekinumab (n = 105, 11.3%), and tofacitinib (n = 11, 1.2%). Upadacitinib, ozanimod, and golimumab were infrequently prescribed (each n < 10). Median time to discontinuation of 1L AT was longest for vedolizumab (567 days [95% CI, 472-672]), followed by adalimumab (400 days [95% CI, 297-701]). Discontinuation risk was numerically lower for vedolizumab than adalimumab (HR, 0.768; p = 0.061), and significantly lower for vedolizumab than infliximab (HR, 0.682; p < 0.001) and ustekinumab (HR, 0.539; p < 0.001).
CONCLUSIONS: Real-world treatment persistence of vedolizumab as a 1L AT is longer than or similar to other ATs in older adults with UC.
METHODS: Claims data from adults with UC aged ≥ 65 years who initiated 1L AT between January 1, 2020 and March 31, 2024 were obtained from Optum’s de-identified Clinformatics® Data Mart Database. Baseline and follow-up were variable periods of continuous enrollment in medical and pharmacy benefits of ≥ 730 days before and ≥ 180 days after AT initiation, respectively. Baseline characteristics and AT distribution were summarized descriptively. Median time to discontinuation (time from AT initiation to AT end date, switching, end of continuous enrollment, or study end) and hazard ratios (HRs) were estimated by Kaplan-Meier analysis and univariable Cox proportional hazards models, respectively, with 95% confidence intervals (CIs).
RESULTS: Of 926 patients, 446 (48.2%) were male, the mean (standard deviation [SD]) age was 73.7 (5.4) years, and most (n = 850, 91.8%) had Medicare coverage. Mean (SD) Charlson Comorbidity Index and UC severity scores were 3.4 (2.9) and 11.2 (6.8), respectively. The most frequently prescribed 1L AT was vedolizumab (n = 445, 48.1%), followed by infliximab (n = 241, 26.0%), adalimumab (n = 111, 12.0%), ustekinumab (n = 105, 11.3%), and tofacitinib (n = 11, 1.2%). Upadacitinib, ozanimod, and golimumab were infrequently prescribed (each n < 10). Median time to discontinuation of 1L AT was longest for vedolizumab (567 days [95% CI, 472-672]), followed by adalimumab (400 days [95% CI, 297-701]). Discontinuation risk was numerically lower for vedolizumab than adalimumab (HR, 0.768; p = 0.061), and significantly lower for vedolizumab than infliximab (HR, 0.682; p < 0.001) and ustekinumab (HR, 0.539; p < 0.001).
CONCLUSIONS: Real-world treatment persistence of vedolizumab as a 1L AT is longer than or similar to other ATs in older adults with UC.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO91
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Gastrointestinal Disorders, STA: Biologics & Biosimilars