Trends of 5-Aminosalicylate Medication Use in Patients With Crohn Disease.

Document Type

Article

Publication Date

3-15-2021

Publication Title

Inflammatory bowel diseases

Abstract

BACKGROUND: 5-aminosalicylate (5-ASA) medications have a long history of use for the treatment of inflammatory bowel disease and continue to be widely prescribed today. The effectiveness of 5-ASAs in ulcerative colitis is clear; however, studies have shown little benefit for induction or maintenance treatment of Crohn disease (CD). We aimed to quantify usage and examine trends in 5-ASA prescription rates in patients with CD.

METHODS: Using a retrospective design, we queried a national database of commercially insured patients (Truven-Health databases) between 2009 and 2014 to identify patients with CD aged 18 to 65 years. Prescription rates for 5-ASA medications including sulfasalazine, mesalamine, olsalazine, and balsalazide were calculated for each calendar year. Regression models were used to examine year-to-year trends in prescription rates and identify patient factors associated with 5-ASA use.

RESULTS: We identified 132,804 patients with CD, of whom 37.3% (n = 49,529) received a 5-ASA prescription during the study period. From 2009 to 2014, the overall prescription rates of 5-ASAs declined from 42.9% to 30.0% (P < 0.001). Patient factors independently associated with 5-ASA use included younger age, male sex, multimorbidity, and a health maintenance organization insurance plan, while controlling for the region of residence.

CONCLUSIONS: About 1 in 3 privately insured patients with CD received 5-ASA prescriptions despite their questionable effectiveness; however, in an encouraging trend, prescription rates significantly decreased from 2009 to 2014. This high prescription rate may reflect a gap in providers' knowledge regarding the available evidence-an opportunity for cost savings with improved health care delivery.

Volume

27

Issue

4

First Page

516

Last Page

521

DOI

10.1093/ibd/izaa127

ISSN

1536-4844

PubMed ID

32469067

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