Treatment patterns among pediatric and adult patients with ulcerative colitis in the United States: a retrospective cohort study

OBJECTIVE: To assess treatment patterns among pediatric and adult patients with ulcerative colitis (UC) in the United States (US) during 1- and 3-year follow-up periods. METHODS: This observational, claims-based cohort study utilized Merative MarketScan Research Databases between 1 January 2014 and 31 December 2021. The index date was defined as first UC diagnosis during study period. Among pediatric and adult UC cohorts, patients were stratified into two subgroups: (a) previously diagnosed (presence of UC claim) and (b) newly diagnosed (absence of UC claim) in the 12-month pre-index period. Treatment patterns during 1- and 3-year follow-up were reported descriptively for both cohorts. Patients without a > 60-day therapy gap were considered persistent. RESULTS: = 37,673) were 13.7 and 48.8 years, respectively. Most pediatric and adult patients initiated UC treatment with monotherapy in previously diagnosed (74.8% and 76.1%) and newly diagnosed (58.0% and 74.9%) subgroups. Corticosteroids were initiated earlier in newly diagnosed pediatric patients than in adults during the 1-year follow-up (9 vs 47 days). Pediatric and adult patients in both subgroups had similar persistence rates of advanced therapies (ATs) (>80%). A small proportion (1.1% to 4.9%) of pediatric patients received an off-label AT. Newly diagnosed pediatric patients initiated concomitant UC therapies with ATs more frequently than adults. CONCLUSION: The early corticosteroid initiation, concomitant therapy use with ATs, and frequent switching observed in this study underscore unmet need in pediatric UC, given the limited number of ATs approved for pediatric use.