Curr Med Res Opin. 2022 Oct 20:1-19. doi: 10.1080/03007995.2022.2135836. Online ahead of print.
ABSTRACT
OBJECTIVES: To assess treatment patterns and initial and maintenance dosing of biologics over 3 years in pediatric patients with ulcerative colitis (UC) or Crohn’s disease (CD), utilizing data from the ImproveCareNow registry.
METHODS: Pediatric patients diagnosed with UC or CD and aged 2-17 years were included in the study. Descriptive statistics were employed to summarize baseline demographics. The proportion of patients on medication for UC or CD were analyzed at the baseline visit, 1-year, and 3-year time points (Cohort 1). Biologic maintenance dosage was calculated only for patients who had data for dose and weight at all time points (Cohort 2).
RESULTS: In Cohort 1 (UC =1784; CD =4720), baseline treatment in UC included corticosteroid, 5-ASA, and 6-MP/AZA; at 1-year and 3-year time points, treatment with 5-ASA and corticosteroid decreased, whereas 6-MP/AZA and anti-TNFs increased. In CD, baseline treatment included corticosteroid, anti-TNF, 6-MP/AZA, and methotrexate; use of corticosteroids decreased, whereas the use of methotrexate and anti-TNFs increased over 3 years. In Cohort 2 (UC =350; CD =1,537), at first maintenance dose, UC patients on infliximab received a mean dose of 10.5mg/kg/8wk, adalimumab (weight <40kg and ≥40kg) 1.3mg/kg/2wk and 0.8mg/kg/2wk, and vedolizumab 6.9mg/kg/8wks. At the first maintenance dose, CD patients on infliximab received a mean dose of 8.1mg/kg/8wk, adalimumab (weight <40kg) 1.1mg/kg/2wk, adalimumab (weight ≥40kg) 0.8mg/kg/2wk, and vedolizumab 10.5mg/kg/8wks.
CONCLUSION: The use of corticosteroids was common at the initial visit in patients. Anti-TNFs remain the most used class of biologics, however, reported doses in our study were substantially higher than the standard dosing guidelines.
PMID:36263735 | DOI:10.1080/03007995.2022.2135836
