Real-world analysis of drug treatment for ulcerative colitis using medical claims database

[Speaker] Motohiro Okayasu:1
[Co-author] Yuji Yoshiyama:1
1:Community Pharmacy, Kitasato University School of Pharmacy, Japan

Oral corticosteroids (OCS) are often effective at the beginning of the treatment of ulcerative colitis (UC), but patients often become dependent on OCS. Long-term OCS therapy may increase the risk of adverse drug reactions. It is essential to discontinue OCS therapy as soon as possible. It has been reported that the effect of OCS should be assessed at week 1 or 2 of treatment, and patients not responding to OCS should receive additional drugs or switch to other treatments. This study aimed to clarify the actual use of OCS in UC using a medical claims database in Japan.
A medical claims database provided by the Japan Medical Data Center was used to analyze data from January 2008 to December 2014 to clarify real-world OCS use in terms of the percentage of UC patients receiving OCS, the distribution of OCS dose, total dose of OCS from the beginning of OCS therapy to the cut-off point, and UC duration before initiating OCS.
Analysis revealed that OCS therapy is becoming less common in UC patients. The percentage of OCS users has decreased year by year, and that in naive patients who were diagnosed as UC during the survey period decreased significantly each year (p<0.001). About 50% of naive UC patients were prescribed with OCS within one month after the diagnosis. Only a small number of naive UC patients started OCS in the second month or thereafter. About 25% of naive UC patients prescribed with OCS continued OCS therapy more than 6 months.
Although there are limitations to the medical claims data, our analysis indicated that OSC therapy is becoming less common and this tendency is particularly strong in naive UC patients. The study also revealed that some UC patients receive OCR for a considerable length of time in the clinical setting.
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