Estimation of patients affected by inflammatory bowel disease potentially eligible for biological treatment in a real-world setting

Dig Liver Dis. 2024 Jan;56(1):29-34. doi: 10.1016/j.dld.2023.04.022. Epub 2023 May 3.

Abstract

Background/aims: This analysis estimated the number of inflammatory bowel disease (IBD) patients presenting criteria of eligibility for biological therapies in an Italian real-world setting.

Methods: An observational analysis was performed on administrative databases of a sample of Local Health Units, covering 11.3% of the national population. Adult IBD patients (CD or UC) from 2010 to the end of data availability were included. Eligibility criteria for biologics were the following: Criterion A, steroid-refractory active disease; Criterion B, steroid-dependent patients; Criterion C, intolerance or contraindication to conventional therapies; Criterion D, severe relapsing disease; Criterion E (CD only), highly active CD disease and poor prognosis.

Results: Of 26,781 IBD patient identified, 18,264 (68.2%) were treated: 3,125 (11.7%) with biologics and 15,139 (56.5%) non-biotreated. Among non-biotreated, 7,651 (28.6%) met at least one eligibility criterion for biologics, with criterion B (steroid-dependence) and criterion D (relapse) as the most represented (58-27% and 56-76%, respectively). Data reportioned to the Italian population estimated 67,635 patients as potentially eligible for biologics.

Conclusions: This real-world analysis showed a trend towards undertreatment with biologics in IBD patients with 28.6% being potentially eligible, suggesting that an unmet medical need still exists among the Italian general clinical practice for IBD management.

Keywords: Biologics; Inflammatory-bowel disease; Real-world evidence.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Biological Products* / therapeutic use
  • Colitis, Ulcerative* / epidemiology
  • Crohn Disease* / epidemiology
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Inflammatory Bowel Diseases* / epidemiology
  • Recurrence
  • Steroids / therapeutic use

Substances

  • Biological Products
  • Steroids