P479 Trends in medication use and treatment patterns in Chinese patients with Inflammatory Bowel Diseases: A multicenter cohort study from 1999 to 2020
Yao, L.(1);Shao, B.(1);Cao, Q.(1);
(1)Sir Run Run Shaw Hospital- College of Medicine Zhejiang University, Department of Gastroenterology, Hangzhou, China;
The temporal changes in medication use and therapeutic paradigm in patients with Inflammatory bowel disease (IBD) have not been well elucidated in China over the past two decades. Therefore, we aimed to identify the temporal changes in medication use and treatment patterns for Chinese patients with IBD and to evaluate the factors associated with initial drug strategies.
A multicenter retrospective cohort study was conducted among Chinese patients newly diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC) from January 1999 to December 2019. Medication utilization, treatment patterns, and associated factors with initial drug strategies were investigated.
Prescriptions of 5-aminosalicylates (ASA) and corticosteroids (CS) gradually decreased, whereas prescriptions of immunosuppressants (IMS) and infliximab (IFX) increased in patients with CD. Except for stable prescriptions of ASA and CS, IMS and IFX increased since 2007 in patients with UC. Subgroup (N=957) analyses revealed that treatment patterns went through notable changes from ASA to IMS or IFX in patients with CD, while ASA and CS were still steadily prescribed in patients with UC. Logistic regression analyses revealed that perianal and gastrointestinal surgeries before diagnosis, disease behavior, and disease location were associated with different initial therapeutic strategies in patients with CD. However, medications before diagnosis, disease location, and diagnostic year might affect initial strategies in patients with UC.
Parallel to increasing uses of IMS and IFX in IBD over past two decades, a significant decrease in uses of ASA and CS were observed in CD, but not in UC. Treatment strategies analyses provided a unique insight in understanding long-term therapeutic patterns in the Chinese population.