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Trends and demographic patterns in biologic and corticosteroid prescriptions for inflammatory bowel disease: findings from electronic medical records, 2011–2020
  1. Fang Xu,
  2. Yong Liu,
  3. Kurt Greenlund,
  4. Susan Carlson
  1. Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Dr Fang Xu, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; vmf7{at}cdc.gov

Abstract

Prescriptions for biologic therapy for treatment of Crohn’s disease (CD) and ulcerative colitis (UC) have increased during the past two decades; however, trends are less clear regarding corticosteroid prescriptions in this context. We designed a cross-sectional study using the IQVIA Ambulatory Electronic Medical Records databases. Weighted linear regressions by age group were used to estimate annual percentage change from 2011 to 2020 in prescriptions for biologics and for corticosteroids among patients with or without biologic prescriptions within the same calendar year. Using 2019 data, we compared patient demographic and lifestyle risk factors using χ2 test for biologic prescriptions and corticosteroids with or without biologics prescriptions. There was an 11% (CD) and 16% (UC) annual increase in the percentage of patients prescribed biologics during the study period. The percentage of patients with biologics prescriptions prescribed corticosteroids decreased by 2% (CD) and 3% (UC) annually after 2015, while the percentage remained unchanged for corticosteroid prescriptions among patients without biologics. In 2019, differences in medication prescriptions existed by patient’s demographic and lifestyle factors for patients with CD (n=52,892) and UC (n=52,280), including a higher percentage prescribed biologics among younger patients, men, those with fewer comorbidities, and current alcohol drinkers, and a higher percentage prescribed corticosteroids without biologics among women, those with more comorbidities, and a history of smoking. While medications continue to evolve during the biologic era, it is important to continue to monitor trends and differences in prescription patterns to assess progress toward optimizing treatment for patients with CD or UC.

  • anti-inflammatory agents
  • anti-inflammatory agents, non-steroidal
  • inflammatory bowel diseases

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Footnotes

  • Contributors FX: concept and design of the study, data acquisition, analyses, data interpretation, drafting manuscript, critical revision for important intellectual content, manuscript approval for journal submission. YL: concept or design of the study, data acquisition, analyses, data interpretation, critical revision for important intellectual content, manuscript approval for journal submission. KG: data interpretation, critical revision for important intellectual content, manuscript approval for journal submission. SC: concept or design of the study, data interpretation, critical revision for important intellectual content, manuscript approval for journal submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.