Trends in medication use and treatment patterns in Chinese patients with inflammatory bowel disease

Abstract

BACKGROUND Medications for inflammatory bowel disease (IBD) have changed dramatically over time. However, no study on long-term medication profiles has been conducted in the Chinese population. AIM To evaluate temporal changes in medication use and treatment patterns for Chinese patients with IBD. METHODS A multicenter retrospective cohort study was conducted among Chinese patients newly diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC) between January 1999 and December 2019. Baseline characteristics and drug prescriptions were collected. Trends in medication use and therapeutic patterns were analyzed. RESULTS In total, 3610 patients were analyzed. During follow-up, 5-aminosalicylates (5-ASA) and corticosteroids (CS) prescriptions gradually decreased, accompanied by a notable increase in immunosuppressants (IMS) and infliximab (IFX) prescriptions in patients with CD. Prescription rates of 5-ASA and CS were stable, whereas IMS and IFX slightly increased since 2007 in patients with UC. Subgroup ( n = 957) analyses showed a switch from conventional medications to IFX in patients with CD, while 5-ASA and CS were still steadily prescribed in patients with UC. Logistic regression analyses revealed that surgical history, disease behavior, and disease location were associated with initial therapeutic strategies in patients with CD. However, medications before diagnosis, disease location, and diagnostic year might affect initial strategies in patients with UC. CONCLUSION Long-term treatment strategies analyses has provided unique insight into the switch from conventional drugs to IFX in Chinese patients with CD.

Geographical heterogeneity in the disease characteristics and management of patients with inflammatory bowel disease, the preliminary results of a Chinese database for IBD (CHASE-IBD)

“…The disease location for UC was comparable between our study and Western populations, 26,30 with roughly equal proportions of E1, E2, and E3. However, the proportion of E3 was less than that (47.1%) in a recently published multicenter study in China, 24 possibly because this was a follow-up study with a longer disease duration in patients with UC than that in our study. For patients with CD, L3 and B1 were the most frequent disease locations and behaviors, similar to other cohorts in Asia.…”

“…In terms of disease characterization, the median age at CD diagnosis was notably lower than that for UC, consistent with previous studies in China. 12,13,23–25 The median age at diagnosis for patients with UC (40.69 years) seemed to be older than that in Europe (median: 37; IQR: 27–55 years), 26 while the median age at diagnosis for patients with CD (28.58 years) seemed to be younger than that in Europe (median: 33; IQR: 23–49 years). 27 The median age at diagnosis for patients with UC and CD was younger than previous studies, 12,23,25 but similar to the results of a recently published study in China.…”

“…27 The median age at diagnosis for patients with UC and CD was younger than previous studies, 12,23,25 but similar to the results of a recently published study in China. 24 This indicates that the age at diagnosis of patients with IBD in China is gradually decreasing. Additionally, the median disease duration was shorter in this study.…”

“…For patients with CD, L3 and B1 were the most frequent disease locations and behaviors, similar to other cohorts in Asia. 24,28,31,32 In addition, heterogeneity in the distribution of disease location and behavior was observed between Eastern and Western China. The proportions of L1 and L4 in Eastern China were higher than in Western China, whereas the proportion of L2 was lower.…”

Low-dose ganciclovir ameliorates dextran sulfate sodium-induced ulcerative colitis through inhibiting macrophage STING activation in mice

“…Clinically, the present treatment of IBD are 5-salicylic acid inhibitors, corticosteroids and immunosuppressants. Moreover, some new targeted drugs such as infliximab (a monoclonal antibody against tumor necrosis factor-α /TNF-α), ustekinumab (a monoclonal antibody against the p40 subunit of interleukin 12/23), and adalimumab (a fully human neutralizing anti-TNFα monoclonal antibody) are also used to treat IBD patients ( Fiske et al, 2022 ; Lerang et al, 2022 ; Song et al, 2022 ; Wasserbauer et al, 2022 ; Yao et al, 2022 ). Animal models of colitis have been established to investigate its mechanisms and are used to evaluate efficacy of potential anti-inflammatory agents.…”