(183) Impact of COVID-19 on non-COVID related treatment patterns and outcomes in patients with inflammatory bowel disease (IBD)

Background: : The COVID-19 epidemic disrupted healthcare delivery and access to non-COVID related care globally.

Objective: : To determine the effect of COVID-19 restrictions on treatment patterns, COVID vaccination rates, and outcomes among patients treated with advanced therapies for IBD.

Methods: : Adult patients diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC) were identified in PearlDiver’s Mariner170 claims database. Included patients were treated with advanced therapy (adalimumab, certolizumab, golimumab, infliximab, vedolizumab, ustekinumab, etanercept, rituximab, natalizumab, baricitinib, or tofacitinib) between 2018 and 2022. Rates of COVID vaccination visible in claims (ICD-10-P-XW013S6, ICD-10-P-XW013T6, ICD-10-P-XW013U6, ICD-10-P-XW023S6, ICD-10-P-XW023T6, ICD-10-P-XW023U6, CPT-0001A, CPT-0002A, CPT-0003A, CPT-0011A, CPT-0012A, CPT-0013A, CPT-0031A) COVID infection (ICD-10-D-U071), changes in IBD treatment patterns, and IBD-related hospitalizations were evaluated by calendar year. Patients were matched using propensity scores 1:1 with individuals with no history of IBD diagnosis (controls).

Results: : A total of 143,806 patients (58% female) with IBD were included. Overall, patients with IBD were more likely to receive a COVID-19 vaccine (5.4%) vs controls (2.6%). COVID-19 infection rates were higher in the IBD population (13.0%) vs controls (9.2%). From 2018 to 2022, adalimumab was the most common treatment (38.6%), followed by ustekinumab (17.9%), infliximab (3.7%), certolizumab (2.9%), and tofacitinib (2.7%). Adalimumab use declined from 44.7% in 2018 to 35.9% in 2022, and certolizumab use declined from 3.9% (2018) to 2.5% (2022); however, ustekinumab use increased from 10.0% (2018) to 27.9% (2022), and tofacitinib, one of the only orally administered options, use increased from 1.4% (2018) to 3.0% (2022). Non-COVID hospitalizations decreased from 13.8% in 2019 to 13.3% in 2020, 12.5% in 2021, and 10.4% in 2022.

Conclusions: : We observed higher COVID-19 vaccination and infection rates among patients with IBD. Non-COVID hospitalizations decreased from 2018 to 2022. Adalimumab was most utilized, but its use decreased over time. Ustekinumab use increased over the same period.

Sponsorship:: Biologics and Biosimilars Collective Intelligence Consortium (BBCIC)