P1116Concomitant medication use in IBD patients receiving subcutaneous biologic therapy: A retrospective cohort analysis using a national prescription database

Abstract Background Patients with inflammatory bowel disease (IBD) receiving biological therapy are regularly reviewed in specialist clinics. Interim consultations with primary care physicians can result in medication prescriptions that may not be captured in specialist records. This could influence symptom reporting and perceived disease activity, potentially impacting clinical decision-making. This study aimed to characterise concomitant medication use among IBD patients receiving subcutaneous biological therapy. Methods We conducted a retrospective cohort analysis of 358 patients with IBD receiving subcutaneous Infliximab (n = 149), Adalimumab (n = 145), or Vedolizumab (n = 64), utilizing a national electronic prescription database. All dispensed prescriptions within the preceding six months were reviewed. Prescription rates for steroids, analgesics, psychiatric medications, antibiotics and other medication classes were quantified and compared across biologic cohorts. Results Of all included patients, only 9.8% (n = 35) received a Steroid prescription over the course of 6 months. Symptom specific medications were dispensed at low rates- Antispasmodics in 2.79% (n = 10) of all patients, Anti diarrhoeal 3.63% (n = 13), Laxatives 1.96% (n = 7) and Anti-emetics 2.51% (n = 9). High prescribing rates were seen in some pertinent medication classes: Antibiotics were prescribed for 22.91% (n = 82) of all patients, Analgesics for 24.02% (n = 86) and Psychiatric medication for 18.44% (n = 66). Patients on Vedolizumab had higher rates of concomitant prescriptions when compared to Infliximab and Adalimumab. Steroid use in 13/64 (20.3%) vedolizumab patients versus 11/149 (7.4%) infliximab and 11/145 (7.6%) adalimumab. Analgesic prescriptions were observed in 21/64 (32.8%), 37/149 (24.8%), and 28/145 (19.3%) respectively. Psychiatric medication use in 21/64 (32.8%), 26/149 (17.5%), and 19/145 (13.1%) respectively. Antibiotic prescription in 22/64 (34.4%), 30/149 (20.1%), and 30/145 (20.7%) respectively. Conclusion Low rates of corticosteroid and symptom-specific medication prescriptions suggest reasonable disease control of IBD patients on subcutaneous biologic therapy. However, the relatively high rates of analgesic, antibiotic, and psychiatric medication use highlight an area of concern, potentially reflecting aspects of patient wellbeing and symptom burden that may not be routinely addressed during specialist review. The higher frequency of concomitant prescriptions observed in the Vedolizumab cohort is a notable finding and warrants further investigation but may relate to Vedolizumab’s mechanism of action. These results underscore the importance of comprehensive medication reconciliation and holistic assessment. Conflict of interest: Dr. Bhupalan, Avinash: No conflict of interest Singh, Harsukhpreet: No conflict of interest Llyod, Ashley: No conflict of interest El-Hakeem, Ali: No conflict of interest Shannon, Eileen: No conflict of interest Slattery, Eoin: No conflict of interest