P1021 Treatment Patterns for Crohn’s Disease: a Multinational Analysis from 2011 to 2022 in the United States, Japan, and China
Authors: Yan L , Xu Y , Gao J , Wu T , Chung H , Jiang K , Suruki R , Zhang Y , Liang J , Qiu H , Wu K 
Published: January 2025

Abstract

Background
Crohn’s Disease (CD) is one of the two major forms of inflammatory bowel disease (IBD) and leads to high disease burden. Early and effective pharmacological treatments is critical to manage CD, however, sparse data on treatment patterns resulted in a gap in our understanding of the alignment between management strategies in practice and existing knowledge and evidence. This multi-country study aimed to describe treatment patterns for CD, providing insights into regional practices and their evolution over time.

Methods
Employing a retrospective cohort design, three large-scale healthcare electronic databases between 2011 and 2022 from the U.S., Japan and China were used to identify patients diagnosed with CD and those who initiated any treatment within the period. Medications use at treatment initiation and during subsequent treatments, including 5-aminosalicyclic acid (5-ASA), corticosteroids (CS), immunomodulators (IMM) and biologics (BIO) were analysed, and the temporal trend of medication use at treatment initiation was assessed by the annual percent change (APC) to identify shifts in treatment preferences over the period.

Results
We identified 93,573 CD patients in the U.S. cohort, 9,617 in the Japan cohort, and 928 in the China cohort, respectively. CS was the most used medication at treatment initiation (64.2%) for the U.S. cohort, while 5-ASA was the predominant medication for Japan and China cohorts (63.9% and 63.5%, respectively). BIO was utilized at treatment initiation by 12.7%, 28.5% and 10.0% of patients in the cohorts from the U.S., Japan and China, respectively. During subsequent treatment, CS or 5-ASA remained more common than BIO in the U.S. and China cohorts, while BIO use was higher in the Japan cohort. Regarding the trends from 2011 to 2022, percentage of patients using 5-ASA or IMM at treatment initiation significantly declined for the U.S. and Japan cohorts. Conversely, percentage of patients using CS at treatment initiation rose significantly for the U.S. cohort, along with a marked increase in utilization in the China cohort from 2018 to 2022. Percentage for BIO also increased significantly for the U.S. and China cohorts while it declined for the Japan cohort.

Conclusion
This study documented treatment patterns for CD by leveraging healthcare databases from 3 countries, providing insights into real-world clinical practices. These findings indicate significant variability in medication used at treatment initiation and subsequent treatments across the countries studied. These insights underscore the need for continuous evaluation and adaptation of treatment strategies to align with evolving evidence-based guidelines and improve patient outcomes.

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