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PTH-071 Indicators of Suboptimal Therapy Among Crohn’s Disease Patients Treated with Tumour Necrosis Factor Antagonists: Results from A Multi-National Study
  1. A Armuzzi1,
  2. J Lindsay2,
  3. R Mody3,
  4. B Bokemeyer4,
  5. J Gisbert5,
  6. L Peyrin-Biroulet6,
  7. G Nguyen7,
  8. J Siebenaler8,
  9. Ö Åkerborg9,
  10. M Smyth10,
  11. A Rathmell11
  1. 1IBD Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
  2. 2Department of Gastroenterology, Barts Health NHS Trust, London, UK
  3. 3Takeda Pharmaceuticals International Inc, Deerfield, United States
  4. 4Gastroenterology Practice, Minden, Germany
  5. 5Hospital Universtario de La Princesa, Madrid, Spain
  6. 6CHU de Nancy – Hôpital Brabois, Vandœuvre-lès-Nancy, France
  7. 7Mount Sinai Hospital, Toronto, Canada
  8. 8MAPI, Milton, United States
  9. 9MAPI, Stockholm, Sweden
  10. 10Takeda Development Centre Europe Ltd, London, UK
  11. 11Takeda UK Ltd, Medical Affairs, Wooburn Green, UK

Abstract

Introduction Crohn’s disease (CD) patients treated with tumour necrosis factor antagonists (anti-TNFs) may require therapy changes over time, which may be considered as indicators of suboptimal therapy.

Methods A multi-national, multicentre, retrospective, chart review study was conducted to assess the indicators of suboptimal therapy among adult CD patients receiving their first anti-TNF [infliximab (IFX) or adalimumab (ADA)] between June 2009 and June 2011 (index therapy). The indicators of suboptimal therapy during 2 year follow up were: anti-TNF dose-escalation (assessed >4 months after index to allow for initial dose adjustments), augmentation with a non-biologic drug, discontinuation of first anti-TNF, switching to another anti-TNF and CD-related surgery. The percentages of patients with each indicator type and ≥1 indicator by country for each anti-TNF drug are summarised descriptively.

Results The study included 657 CD patients with mean age (SD) of 39.2 (13.2) years, 51% females, 51% with moderate to severe CD at index, 44% and 56% on ADA and IFX, respectively and 71% on combination therapy with a non-biologic drug. Overall, 56% of CD patients had ≥1 indicator of suboptimal therapy, 20% of patients had dose escalation, 18% needed augmentation with a non-biologic, 29% discontinued first anti-TNF, and 17% underwent a CD-related surgery. Of those who discontinued (N = 183), 70% switched to another anti-TNF.

Conclusion In this large multi-national cohort, over half of the CD patients had ≥1 indicator of anti-TNF suboptimal therapy. Predominant indicators included dose escalation, discontinuation and switching to another anti-TNF.

Disclosure of Interest A. Armuzzi Grant/research support from: MSD, Consultant for: Abbvie, Hospira, Liily, MSD, Mundipharma, Pfizer, Sofar, Takeda, Speaker bureau with: Abbvie, Astra-Zeneca, Chiesi, Ferring, Hospira, MSD, Otsuka, Takeda, Zambon, J. Lindsay Grant/research support from: MSD, Abbvie, Hospira, Takeda, Janssen, Ferring, Shire Pharmaceuticals, Vifor Pharma, Atlantic Health care, Actavis (Warner Chilcott), and Tillotts, Consultant for: MSD, Abbvie, Hospira, Takeda, Janssen, Ferring, Shire Pharmaceuticals, Vifor Pharma, Atlantic Health care, Actavis (Warner Chilcott), and Tillotts, Speaker bureau with: MSD, Abbvie, Hospira, Takeda, Janssen, Ferring, Shire Pharmaceuticals, Vifor Pharma, Atlantic Health care, Actavis (Warner Chilcott), and Tillotts, R. Mody Employee of: Takeda Pharmaceuticals International, Inc, B. Bokemeyer Grant/research support from: Abbvie, Ferring, UCB, Consultant for: Abbvie, MSD, Shire, Ferring, UCB, Hospira, Takeda, Movetis, Speaker bureau with: Abbvie, Ferring, MSD, Merckle, Falk, HLR, UCB, J. Gisbert Grant/research support from: MSD, Abbvie, Hospira, Kern Pharma, Takeda, Janssen, Pfizer, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, Vifor Pharma, Consultant for: MSD, Abbvie, Hospira, Kern Pharma, Takeda, Janssen, Pfizer, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, Vifor Pharma, Speaker bureau with: MSD, Abbvie, Hospira, Kern Pharma, Takeda, Janssen, Pfizer, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, Vifor Pharma, L. Peyrin-Biroulet Consultant for: Abbvie, MSD, Jansse, Takeda, Hospira, Celltrion, Biogaran, Speaker bureau with: Abbvie, MSD, Janssen, Takeda, Mitsubishi, G. Nguyen Consultant for: Janssen and Abbvie, J. Siebenaler Conflict with: Employee of Mapi, a company hired to conduct the study by Takeda Pharmaceuticals International, Inc., Ö. Åkerborg Conflict with: Employee of Mapi, a company hired to conduct the study by Takeda Pharmaceuticals International, Inc., M. Smyth Employee of: Takeda Development Centre Europe Ltd, London, UK

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