Why Patients Switch Biologics In UC & CD

Real-World Biologic Treatment Prescribing Patterns & Reasons For Discontinuation In Patients With UC & CD

This poster was originally presented at ISPOR 2025 on May 15, in Montreal, QC, Canada. 

Authors: Abbey Nakano, PharmD; Dave Iwanyckyj, BA; Fernando Otalora; John Perez; Melanie Jardim, PhD 

Affiliations: Amplity, Inc., Langhorne, PA, USA 

Introduction 

This study aims to assess real-world prescribing patterns of biologics and explore factors driving therapy change for patients with ulcerative colitis (UC) and Crohn’s disease (CD). 

Methods  

• This retrospective observational study used natural language processing (NLP) to search and analyze the Amplity AnswerY™ database and platform, which was built from HIPAA-compliant transcriptions of U.S. prescriber–patient visits, for patients diagnosed with UC or CD. 

• Using AI and natural language processing (NLP), it extracts, visualizes, and summarizes treatment discussions and clinical decisions. Covering inpatient and outpatient care across 70+ specialties since 2017, AnswerY was known as Amplity Insights™ prior to January 2025. 

•  AnswerY was queried for patients with a diagnosis of UC or CD who were prescribed at least 1 biologic therapy. 

• Trends in prescribing habits were gathered for all-time records, then split by records before 2023 and 2023 onward to understand influence of biosimilar adoption on prescribing habits. 

Results 

According to Figure 1: 

• All-time, the most common first-line biologics prescribed for patients with UC were adalimumab (41.21%) and infliximab (36.00%), followed by vedolizumab (15.60%). 

• Second-line therapy for patients with UC included infliximab (33.30%), vedolizumab (30.40%), and adalimumab (23.50%). 

•  These trends were similar for ≤2022 and ≥2023. 

Figure 1: All-Time Biologic Treatment Sequencing For Patients With UC: 2017-2024 

According to Figure 2:

• All-time, the most common first-line biologics in patients with CD were adalimumab (39.70%) and infliximab (32.60%), followed by vedolizumab (32.20%). 

• Second-line therapy was distributed among infliximab (28.50%), adalimumab (26.00%), ustekinumab (19.80%), and vedolizumab (19.67%). 

• These trends were similar for ≤2022 and ≥2023. 

Figure 2: All-Time Biologic Treatment Sequencing For Patients With CD: 2017-2024

Adverse Effects:

• The most frequently reported reasons for discontinuing first-line biologic therapy were adverse events and efficacy. 

• In patients with UC, first-line vedolizumab was discontinued due to adverse events more often than first-line infliximab and adalimumab.  

• In patients with CD, vedolizumab was discontinued due to patient preference more often than first-line infliximab and adalimumab. 

Conclusion 

• Analysis of the AnswerY database shows adalimumab and infliximab are the most utilized first-line biologics, with a wider range of agents used in second-line therapy.  

• Using AI and NLP to review patient–provider transcripts, AnswerY was able to track prescribing trends through lines of therapy and identify reasons for treatment discontinuation.  

• The most common reasons for discontinuation of first-line biologic therapy were adverse events and efficacy.  

• This real-world data can be used to further understand the treatment landscape of biologics in the treatment of IBD. 

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