Kastl Art, Gibble Theresa Hunter, Tinsley Debbie, Crandall Wallace V, Komocsar Wendy J, Du Yu, Choong Casey K, Jha Payal, Chan Wai Man Maria
Children'S Hospital of Philadelphia, Philadelphia, USA.
Eli Lilly and Company, Indianapolis, USA.
Drugs Real World Outcomes. 2025 Apr 8. doi: 10.1007/s40801-025-00489-8.
The advent of biologics has expanded treatment options for Crohn's disease (CD). This study assessed treatment patterns in pediatric and adult patients with CD in the United States during 1- and 3-year follow-up periods.
This retrospective, claims-based cohort study utilized the Merative™ MarketScan Research Databases from January 1, 2014, to December 31, 2021. The index date was the date of the first CD diagnosis during the identification period. Among pediatric and adult CD cohorts, patients were stratified into two subgroups: (a) previously diagnosed (presence of a CD claim) and (b) newly diagnosed (absence of a CD claim) in the 12-month pre-index period. Results were summarized descriptively.
Data from 2809 pediatric and 25,940 adult patients were analyzed at 1-year follow-up. Mean age in years was 13.5 for pediatric and 46.0 for adult patients. Combination therapies were more common in pediatric versus adult patients, especially among those newly diagnosed with CD (38.2% vs 13.9%). A higher percentage of pediatric patients were prescribed biologics than adults (35.1% vs 24.3%). Numerically shorter time from diagnosis to corticosteroid initiation was observed in pediatric versus adult patients (9.5 vs 35 days). Higher persistence to biologics was observed in pediatric versus adult patients (94.6% vs 87.1%).
Combination therapies with biologics were more frequent among pediatric patients than adults. Although the overall treatment pattern among pediatric and adult patients was similar, early initiation of corticosteroids and adoption of biologics were more frequently observed in pediatric than adult patients, consistent with pediatric CD presenting with more aggressive disease.
生物制剂的出现扩大了克罗恩病（CD）的治疗选择。本研究评估了美国儿童和成人CD患者在1年和3年随访期内的治疗模式。
这项基于索赔的回顾性队列研究使用了2014年1月1日至2021年12月31日的Merative™ MarketScan研究数据库。索引日期为识别期内首次CD诊断的日期。在儿童和成人CD队列中，患者被分为两个亚组：（a）在索引前12个月内先前诊断（有CD索赔）和（b）新诊断（无CD索赔）。结果进行了描述性总结。
在1年随访时分析了2809名儿童患者和25940名成人患者的数据。儿童患者的平均年龄为13.5岁，成人患者为46.0岁。联合治疗在儿童患者中比成人患者更常见，尤其是在那些新诊断为CD的患者中（38.2%对13.9%）。儿童患者中使用生物制剂的比例高于成人（35.1%对24.3%）。与成人患者相比，儿童患者从诊断到开始使用皮质类固醇的时间在数值上更短（9.5天对35天）。与成人患者相比，儿童患者对生物制剂的持续使用率更高（94.6%对87.1%）。
儿童患者中生物制剂联合治疗比成人患者更频繁。虽然儿童和成人患者的总体治疗模式相似，但与成人患者相比，儿童患者更频繁地早期开始使用皮质类固醇并采用生物制剂，这与儿童CD表现出更具侵袭性的疾病一致。
