The use of 5-aminosalicylates in Crohn’s disease: a retrospective study using the UK Clinical Practice Research Datalink.
Background: There are few recent studies on the use of 5-aminosalicylates (5-ASA) as therapy for Crohn's disease (CD) in routine clinical practice. The aim of this database investigation was to provide real-world evidence on 5-ASA use in CD.
Methods: Patients with CD, aged >/=18 years when first prescribed 5-ASA (index date) and having received 5-ASA at any time between 01 January 2006 and 07 May 2018, were included for analysis. Outcomes included treatment patterns and resource use.
Results: Of 21,456 patients with CD, 9492 (44.2%) had been prescribed 5-ASA, with the majority (5606; 59.1%) starting on oral 5-ASA as monotherapy. 58.3% (5537) of patients on 5-ASA did not require dose change, 67.6% (6416) did not require supplementary treatment (e.g., corticosteroids, immunosuppressants, etc.), and 4.6% (436) required a switch to another treatment. Resource use was significantly decreased in the year after vs. year before 5-ASA initiation (including: specialist referrals, hospitalizations and hospital days; all P<0.001). Patients remained on 5-ASA for a median of 4.7 years (interquartile range 1.2-10.1). 25.3% (2406) of patients were still on 5-ASA at 10 years. There was a significant correlation between earlier use of 5-ASA following diagnosis and longer 5-ASA retention (P<0.001).
Conclusions: 5-ASA is widely used as a long-term treatment for CD, as evidenced by continuation rates extending beyond 10 years in a quarter of patients. CD-related healthcare resource use decreased significantly in the year following 5-ASA initiation. Earlier use was associated with longer retention.
|ジャーナル名||Annals of gastroenterology|
|投稿者||Hart, Ailsa; Ng, Siew C; Watkins, John; Paridaens, Kristine; Edwards, James O; Fullarton, John R; Sonderegger, Yum Lina Yip; Ghatnekar, Ola; Ghosh, Subrata|
|組織名||Inflammatory Bowel Disease Unit, St Mark's Hospital, Harrow, Middlesex, UK (Ailsa;Hart).;Department of Medicine and Therapeutics, Institute of Digestive Disease, State;Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong;Kong (Siew C. Ng).;Public Health Wales, Cardiff, UK (John Watkins).;School of Medicine, Cardiff University, Cardiff, UK (John Watkins).;Ferring International Center, St-Prex, Switzerland (Kristine Paridaens, Yum Lina;Yip Sonderegger).;Strategen Limited, Winchester, UK (James O. Edwards, John R. Fullarton).;Ferring International PharmaScience Center, Copenhagen, Denmark (Ola Ghatnekar).;Institute of Immunology and Immunotherapy, University of Birmingham, UK (Subrata;Ghosh).|