Z Gastroenterol 2019; 57(05): e133
DOI: 10.1055/s-0039-1691861
POSTER
CED
Georg Thieme Verlag KG Stuttgart · New York

Real World Assessment of Biological Treatment of Inflammatory Bowel Disease at an Austrian Referral Centre: The ULTIMATE Study

HP Gröchenig
1   KH Barmherzige Brüder, St. Veit/Glan, Austria
,
E Walter
2   IPF Institute for Pharmaeconomic Research, Vienna, Austria
,
A Redl
3   Datamedrix GmbH, Vienna, Austria
,
M Bresztowanszky
1   KH Barmherzige Brüder, St. Veit/Glan, Austria
,
K Steidl
1   KH Barmherzige Brüder, St. Veit/Glan, Austria
,
F Siebert
1   KH Barmherzige Brüder, St. Veit/Glan, Austria
,
G Novacek
4   Medical University of Vienna, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2019 (online)

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Background:

Inflammatory bowel diseases (IBD) are characterized by a chronic or relapsing inflammation of affected gut segments leading to progressive gut damage and intestinal complications. Biologics are considered to be effective treatment options nowadays. However, primary nonresponse, loss of response and side effects may occur in a clinically-relevant number of patients. We analysed treatment duration and dose escalations with biologics during treatment periods.

Methods:

This was a retrospective single centre cohort study at an Austrian referral IBD centre. All consecutive patients with Crohn's disease (CD) (n = 93) or ulcerative colitis (UC) (n = 53) who initiated a biologic treatment between 01/2006 – 10/2016 were included. Medical characteristics including details of treatment with biologics were captured from chart review. The study outcomes were treatment duration and the need for dose escalation with biologics. We performed a descriptive analysis.

Results:

In 146 patients 268 treatment lines with biologics were recorded. Median duration of 1st, 2nd, and 3rd line biologic treatments in CD patients were 32.2, 34.9, and 11.8 months, respectively, compared to 21.8, 19.9, and 16.6 months in UC patients. Dose escalation was required in 39.6% of all therapy lines (n = 106). This was required in 34.9% of all 1st line treatments and increased numerically in subsequent lines. The dose was increased by 37.1% compared to the standard dose in all treatment lines. In patients who received over two lines, the dose increase for TNF-alpha-inhibitors was numerically higher compared to vedolizumab (42.3% vs. 33.9%); vedolizumab was primarily used as 2nd and 3rd line treatment.

Conclusion:

The duration of 1st and 2nd biologic treatment lines were both nearly 3 years for CD and nearly 2 years for UC, respectively, and decreased with subsequent treatment lines. Overall, 40% of all IBD patients needed dose escalation of their biologic treatment.