P652 Treatment patterns in patients receiving outpatient care for inflammatory bowel disease in Russian Federation
Uspenskiy, Y.(1);Galagudza, M.(2);Ivanov, S.(3);Fominikh, Y.(3);Dreval, R.(4);Mayorova, O.(1);
(1)St. Petersburg State Pediatric Medical University, Department of Faculty Therapy named after V.A. Valdman, St. Petersburg, Russian Federation;(2)Pavlov First Saint Petersburg State Medical University, Department of Pathophysiology with the Course of Clinical Pathophysiology, St. Petersburg, Russian Federation;(3)Pavlov First Saint Petersburg State Medical University, Department of Internal Medicine of Dentistry Faculty, St. Petersburg, Russian Federation;(4)Center for Social Economy, Administration, St. Petersburg, Russian Federation
Background
There is a global trend of increasing prevalence of inflammatory bowel disease (IBD) worldwide, Russian Federation including. Meanwhile, treatment options for patients with IBD have expanded significantly in recent years with the advent of novel biotherapeutics. However, insufficient information is available on the treatment patterns of Crohn's disease (CD) and ulcerative colitis (UC) in large cities. We aimed to study the levels of usage of different therapeutic agents in the patients with IBD receiving outpatient care in St-Petersburg, Russian Federation.
Methods
In a cross-sectional study lasting from January 1, 2019 to December 31, 2019, the data on drug therapy of adult (> 18 years old) patients with IBD were obtained from 42 outpatient clinics of St. Petersburg. The Wilson's method of 95% confidence interval (CI) determination was used to determine the statistical differences in the levels of usage of different therapeutics. р values ≤ 0.05 were considered significant. The data on continuous variables are presented as “median (25 quartile; 75 quartile)”.
Results
In total, 535 patients were included. Among them, there were 241 and 294 patients with CD and UC, respectively. Mean age of the patients with CD and UC was 40 (29; 59) and 43 (32; 59) years, respectively (p > 0.05). Among the patients with CD, the ileal, colonic, ileocolonic, and other locations were found in 23.4, 37.6, 34.4, and 4.6 %, respectively. In UC patients, we observed proctitis, left-sided colitis and pancolitis in 24.4, 55.2, and 20.4%, respectively. Oral 5-aminosalicylic acid (5-ASA) drugs, topical 5-ASA drugs, oral (both systemic and topical) glucocorticoids, immunosuppressants, and biologicals were used in 89.3 (84.4-92.8), 32.6 (26.7-39.1), 17.5 (13.0-23.1), 16.5 (12.2-22.0), and 7.3% (0.4-11.7) of patients with CD, accordingly. In UC patients, oral 5-ASA, topical 5-ASA, oral (both systemic and topical) glucocorticoids, immunosuppressants, and biologicals were used in 86.2 (81.4-90.0), 63.1 (56.9-68.8), 12.1 (8.6-16.8), 4.4 (2.5-7.7), and 0.8% (0.02-2.7) of cases, accordingly.
Conclusion
Oral 5-ASA is the most commonly used class of drugs in Russian patients with both CD and UC. The use of topical 5-ASA formulations was more common in patients with UC as compared to CD patients, while immunosuppressive drugs were more commonly prescribed to CD vs. UC patients. We found relatively rare use of systemic and topical oral glucocorticoids in the patients with IBD receiving outpatient care. In our cohort, the use of biological agents was minimal, which probably reflects the trend of prescribing biologicals mostly at the specialized clinics.