(HealthDay)—Varied study design and methodology make it difficult to assess real-world trends in adherence and persistence in use of biologics among U.S. adults with inflammatory bowel disease (IBD), according to a review published online March 14 in the Journal of Clinical Pharmacy and Therapeutics.

Shahnaz Khan, M.P.H., from RTI Health Solutions in Research Triangle Park, North Carolina, and colleagues conducted a systematic literature review to assess rates of adherence, persistence, switching, and dose escalations with biologics used to treat IBD in the United States.

The researchers found that the 41 included studies (published from 2012 to 2017) varied greatly in methodology, data sources, population studied, follow-up time, and end point definitions, thus preventing meaningful comparisons across studies. For the studies using a medication possession rate threshold of <80 or <86 percent, between 38 and 77 percent of patients were nonadherent to biologics. In six studies, up to 25 percent of patients discontinued medication within the first three months, while 7 to 65 percent discontinued by 12 months in 13 studies. In addition, in six studies, the switch rate to another biologic ranged from 4.5 to 20 percent among patients who initiated an index biologic. Only four studies reported dose escalations, which ranged from 8 to 35 percent of patients within the first year of therapy.

“Our findings suggest that real-world biologic use may be suboptimal and indicate new therapies and/or additional patient support may be needed,” the authors write.

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