Patient-favored discontinuation improved with Entyvio, Stelara in IBD
Patient preference favoring treatment discontinuation was improved during treatment with Entyvio or Stelara compared with anti-TNF therapy in patients with inflammatory bowel disease, according to study results.
Dana J. Lukin, MD, PhD, of the division of the Jill Roberts Center for IBD at Weill Cornell Medical College, and colleagues wrote that non-adherence to medication presents a critical risk in IBD. However, the reasons why patients prefer biologic discontinuation are not well understood.
“Few studies have retrospectively examined potential risk factors of non-adherence in patients who discontinued biologic therapy,” they wrote. “Identifying IBD patients at risk of biologic discontinuation prior to actual discontinuation would provide opportunities to intervene in a timely fashion, and potentially prevent negative outcomes resulting from unsupervised withdrawal of biologic therapy.”
Researchers analyzed data collected from a 22-question survey of 190 patients with IBD on biologic therapy. They compared patient preference for discontinuation between anti-TNF therapy and treatment with Entyvio (vedolizumab, Takeda) or Stelara (Ustekinumab, Janssen) and assessed risk factors associated with preference to discontinue biologic therapy.
Among the patients who submitted the survey, 63% had Crohn’s disease, 56% were on anti-TNF therapy, 31% were on vedolizumab and 14% were on ustekinumab.
Thirty-two percent of patients reported a preference to discontinue biologic therapy. The anti-TNF group had a higher proportion of patients with that preference compared with a combined vedolizumab/ustekinumab group (39.6% vs. 21.4%; P < .01).
Patients in the survey indicated that the most concerning factors was a perceived risk for side-effects, with patients on vedolizumab and ustekinumab perceiving their treatment as safer than patients who received an anti-TNF (P = .04).
Additionally, current vedolizumab or ustekinumab use was associated with reduced odds of patient preference favoring biologic discontinuation (adjusted OR = 2.67; 95% CI, 1.42-5.01).
“Individuals at risk of biologic discontinuation or non-adherence will provide opportunities to intervene and prevent risks associated with unplanned withdrawal of biologic therapy,” Lukin and colleagues wrote. “Further studies are required to identify the relationship between preferences favoring discontinuation while undergoing therapy and subsequent non-adherence, as well as whether interventions based on patient preference influence outcomes.”