{
  "abstract": "Introduction Inflammatory bowel disease (IBD) has multiple therapy options and personalized treatment is essential. Some patients (pts) have comorbidities contraindicating anti-tumour necrosis factor (anti-TNF) treatment; the objective of the REFINE study was to describe these groups and their treatment patterns.Methods This was a retrospective analysis of data from administrative health and care registries and regional hospital data lakes in Finland. Adults with ICD-10 diagnosis of Crohn’s ­disease (CD; K50) or ulcerative colitis (UC; K51) after Jan 2000 who started their first advanced IBD therapy from Jan 2018 were eligible. Primary objectives were to estimate the proportion of pts ineligible for anti-TNF when starting their first advanced treatment (such as vedolizumab [VDZ]) and describe their demographics/clinical characteristics. Contraindications were identified from previous publications. Statistical analyses were descriptive and stratified by subgroups (CD/UC, first advanced treatment and anti-TNF contraindication [overall, absolute, relative]).Results Of the 3220 pts with IBD included, 540 (16.8%) had a contraindication – 172 (5.3%) absolute and 368 (11.4%) relative. Among pts with a contraindication, 52% were male and the mean (standard deviation) age was 55 (17) years at IBD diagnosis and 64 (14) years at the start of advanced treatment. The proportion of pts with IBD and a contraindication increased over time from 13.4% (n=64/477) in 2018 to 19.2% (n=137/714) in 2022. Table 1 shows the proportion of pts ineligible for anti-TNF treatment owing to contraindications by first advanced treatment. Most pts without contraindications received anti-TNF, while proportions receiving VDZ increased with relative contraindications and became the predominant treatment in pts with absolute contraindications. Among pts with an anti-TNF contraindication, those with VDZ or anti-TNF as their first advanced treatment had the same three most frequently reported contraindications: age ≥ 65 years, history of malignancy/neoplasia and concomitant malignancy/neoplasia (data not shown).Conclusions A notable proportion of Finnish adults with IBD are ineligible for anti-TNF treatment, highlighting the need for personalized treatment and consideration of alternative advanced therapies. This study indicates that contraindications to anti-TNF in pts with IBD influences treatment choice.Study/writing funding: Takeda Pharmaceuticals International AG, Zurich, Switzerland.Abstract P233 Table 1First advanced treatment, n (%)No anti-TNF treatment contraindication (n = 2680)Anti-TNF treatment contraindicationOverall (n = 540)Relativea (n = 368)Absoluteb (n = 172)Anti-TNF2443 (91.2)275 (50.9)211 (57.3)64 (37.2)VDZ95 (3.5)226 (41.9)131 (35.6)95 (55.2)Otherc142 (5.3)39 (7.2)26 (7.1)13 (7.6)aExamples: age ≥ 65 years and history of neoplasia/malignancy; bExamples: chronic cardiac failure and concomitant neoplasia/malignancy; cReceived anti-IL 12/23 or JAK inhibitors",
  "authors": [
    {
      "affiliations": [
        "Global Medical Evidence, Takeda Pharmaceuticals International AG, Zurich, Switzerland"
      ],
      "name": "Patricia Biedermann"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Turku University Hospital, Turku, Finland"
      ],
      "name": "Jukka Koffert"
    },
    {
      "affiliations": [
        "Medaffcon Oy, Espoo, Finland"
      ],
      "name": "Juhani Aakko"
    },
    {
      "affiliations": [
        "Global Medical Affairs, Takeda Pharmaceuticals International AG, Zurich, Switzerland"
      ],
      "name": "Sigurd Ørstavik"
    },
    {
      "affiliations": [
        "Abdominal Centre, Division of Gastroenterology, Helsinki University Hospital, Helsinki, Finland"
      ],
      "name": "Johanna Haapamäki"
    }
  ],
  "title": "P233 Epidemiology and characteristics of adult patients with inflammatory bowel disease ineligible for anti-tumour necrosis factor treatment: real-world evidence from REFINE",
  "uid": "2ddfa13b-8cfe-5846-8452-59049db92a1c"
}