Analysis Group Inc., Montréal, Canada.
Janssen Scientific Affairs, LLC, a Johnson & Johnson Company, Horsham, PA, USA.
Curr Med Res Opin. 2024 Sep;40(9):1555-1562. doi: 10.1080/03007995.2024.2388839. Epub 2024 Aug 13.
To describe and compare healthcare resource utilization (HRU) among advanced therapy-naïve and advanced therapy-experienced patients with ulcerative colitis (UC) initiating ustekinumab or vedolizumab in the United States.
Claims data from IQVIA PharMetrics Plus de-identified database (01/01/2015-06/30/2022) were used to identify adult patients with UC initiating ustekinumab or vedolizumab (index date) after 10/21/2019. Baseline characteristics were balanced using inverse probability of treatment weighting. All-cause and UC-related HRU (number of inpatient admissions, inpatient days, emergency department visits, and outpatient visits) were described during the post-index period, and Poisson regression models were used to evaluate associations between index therapy and HRU outcomes. Analyses were performed separately among advanced therapy-naïve or advanced therapy-experienced patients.
A total of 444 (ustekinumab) and 1,917 (vedolizumab) advanced therapy-naïve patients, and 647 (ustekinumab) and 1,152 (vedolizumab) advanced therapy-experienced patients were identified. In advanced therapy-naïve patients, higher rates of UC-related inpatient days (rate ratio [95% confidence interval] = 1.84 [1.15, 3.58]; = 0.004), emergency department visits (1.39 [1.01, 2.17]; = 0.044), and outpatient visits (1.81 [1.61, 2.04]; < 0.001) were observed among patients initiating vedolizumab relative to ustekinumab. In advanced therapy-experienced patients, higher rates of UC-related inpatient admissions (1.47 [1.06, 2.12]; = 0.012), inpatient days (2.18 (1.44, 3.71); < 0.001), and outpatient visits (1.50 (1.19, 1.82); < 0.001) were observed among patients initiating vedolizumab relative to ustekinumab. Results were similar when all-cause HRU was examined.
Among patients with UC with and without advanced therapy experience, higher rates of all-cause and UC-related HRU were observed among those treated with vedolizumab relative to ustekinumab.
描述并比较在美国，初治和既往接受过治疗的溃疡性结肠炎（UC）患者在起始使用乌司奴单抗或维得利珠单抗时的医疗资源利用（HRU）情况。
利用 IQVIA PharMetrics Plus 去标识数据库（2015 年 1 月 1 日-2022 年 6 月 30 日）中的索赔数据，确定在 2019 年 10 月 21 日之后起始使用乌司奴单抗或维得利珠单抗（索引日期）的成年 UC 患者。采用逆概率治疗加权法对基线特征进行平衡。在索引后期间，描述全因和 UC 相关 HRU（住院人数、住院天数、急诊就诊和门诊就诊），并采用泊松回归模型评估索引治疗与 HRU 结果之间的关联。分别在初治和既往接受过治疗的患者中进行分析。
共确定了 444 例（乌司奴单抗）和 1917 例（维得利珠单抗）初治患者，647 例（乌司奴单抗）和 1152 例（维得利珠单抗）既往接受过治疗的患者。在初治患者中，与乌司奴单抗相比，起始使用维得利珠单抗的患者 UC 相关住院天数（调整后比值比 [95%置信区间] = 1.84 [1.15, 3.58]； = 0.004）、急诊就诊（1.39 [1.01, 2.17]； = 0.044）和门诊就诊（1.81 [1.61, 2.04]； < 0.001）的发生率更高。在既往接受过治疗的患者中，与乌司奴单抗相比，起始使用维得利珠单抗的患者 UC 相关住院人数（1.47 [1.06, 2.12]； = 0.012）、住院天数（2.18 [1.44, 3.71]； < 0.001）和门诊就诊（1.50 [1.19, 1.82]； < 0.001）的发生率更高。当考察全因 HRU 时，也观察到了类似的结果。
在有和没有既往治疗经验的 UC 患者中，与乌司奴单抗相比，起始使用维得利珠单抗的患者全因和 UC 相关 HRU 更高。
