Real-World Prescribing Patterns of Certolizumab in the Treatment of Crohn’s Disease

BACKGROUND: Certolizumab (CZP) is a pegylated anti-tumor necrosis factor (TNF) agent approved for the treatment of moderate-to-severe Crohn’s disease (CD). CZP therapy has proven effective and well-tolerated for biologic-naïve patients, as well as anti-TNF-experienced patients with secondary non-response or intolerance. CZP is also the preferred anti-TNF during pregnancy. We sought to describe real-world prescribing patterns of CZP in the treatment of CD.

METHODS: We performed a retrospective cohort study of CD patients treated with CZP at a large multicenter gastroenterology private practice since drug approval in 2014. Data collection included demographics, diagnosis, treatment history, and reason for CZP use. CZP use was classified as one of the following: first-line anti-TNF, prior anti-TNF non-response or intolerance, payor requirements, and/or pregnancy considerations.

RESULTS: A total of 59 patients receiving CZP for the treatment of CD were identified. Mean age was 48 ± 16.1 years and 42 (71%) were female. Median CZP treatment duration was 26 [IQR 9-50] months. Forty-four (78%) patients had private insurance, 12 (20%) were enrolled in Medicare or Medicaid, and 1 was uninsured. Nine (15%) patients were bio-naive. Of the 50 (85%) biologic-experienced patients, 22 were previously treated with 1 agent, 23 received 2 previous agents, and 5 patients received 3 or more previous agents. Reasons for CZP use were as follows: prior anti-TNF non-response or intolerance in 39 (66%), pregnancy considerations in 8 (14%), payor requirements or cost considerations in 6 (10%), first-line anti-TNF in 4 (7%), and other reasons in 2 (3%). To date, 26 (44%) patients remain on CZP with a median treatment duration of 48 [IQR 31-59] months.

CONCLUSION(S): We described real-world utilization of CZP. In our cohort, CZP was most commonly prescribed to biologic-experienced patients with prior anti-TNF non-response or intolerance.