DOSE ESCALATION OF BIOLOGIC THERAPIES IN BIOLOGIC TREATMENT-NAÏVE ADULT PATIENTS WITH ULCERATIVE COLITIS: RESULTS FROM THE ODESSA DATABASE STUDY

In the real-world clinical setting, patients with moderate-to-severe ulcerative colitis (UC) may undergo dose escalation when they lose response to their prescribed biologic treatment. Such of agents has an impact on healthcare utilization and costs have patient outcomes. Currently, limited data exist that compare rates between anti-tumor necrosis factor (anti-TNF) therapies vedolizumab, a gut-selective integrin antagonist, in UC who not previously been treated (bio-naïve patients). ODESSA (real wOrld Dose EScalation outcomeS biologics IBD pAtients) was retrospective cohort study investigating bio-naïve receiving vedolizumab or anti-TNFs (adalimumab, golimumab, infliximab) using from IBM MarketScan Commercial Claims Encounters Medicare Supplemental Databases. Adult ≥1 claim for drug January 1, 2017 December 31, 2018 were selected inclusion, first date defined as index 1 (Figure). Patients eligible if had diagnosis UC, identified based codes, ≥2 claims ≥10 days apart before received ≥60% 6 months after 1. excluded any treatment The maintenance period began third (adalimumab golimumab) fourth (infliximab vedolizumab) pharmacy claim. ≥20% increase mean average daily relative expected approved prescribing information UC. primary endpoint proportions experiencing each drugs 12 initiation dosing entire period. final analysis included 2,628 (vedolizumab, n=554; infliximab, n=758; adalimumab, n=1,316). As consequence low count, golimumab excluded. At months, proportion lowest group (36%) highest adalimumab (44%) (Table). this retrospective, anti-TNFs, among during These seem indicate maintains efficacy less need escalation; however, additional studies are required investigate dose-escalation requirements all treatments.TableProportion escalationView Large Image Figure ViewerDownload Hi-res image Download (PPT)