ArticleThe American journal of gastroenterology2018
Defining an Optimal Adherence Threshold for Patients Taking Subcutaneous Anti-TNFs for Inflammatory Bowel Diseases.
Article in The American journal of gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed.
- Patient-Tailored Interventions to Improve Specialty Medication Adherence: Results from a Prospective Randomized Controlled Trial.The American journal of medicine · 2023Trial
- The SILVER Platter for Patients with Inflammatory Bowel Disease (IBD): An IBD Pharmacy Technician-Led Subcutaneous Biologic Home Delivery Service Is Associated with Sustained Improvement in Adherence and Active Health Management.Digestive diseases and sciences · 2026Article
- Remote monitoring to improve engagement for patients with inflammatory bowel disease: a randomized clinical trial.Crohn's & colitis 360 · 2026Article
- Predicting self-administered biologic nonadherence in Medicare fee-for-service beneficiaries with inflammatory bowel disease using machine learning models.Journal of managed care & specialty pharmacy · 2026Article
- Trajectories of Adherence to Biologics in Patients With Inflammatory Bowel Diseases: A Large-Scale Multi-Regional Italian Study Through the VALORE Distributed Database.Pharmacoepidemiology and drug safety · 2025Article
- Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention.Pharmacy (Basel, Switzerland) · 2025Review
- Designing for medication adherence in inflammatory bowel disease: multi-disciplinary approaches for self-administrable biotherapeutics.EClinicalMedicine · 2024Review
- Estimation of optimal adherence threshold for tumor necrosis factor inhibitors in rheumatoid arthritis.Clinical rheumatology · 2024Article
- High refill-adherence to adalimumab is associated with low disease activity in patients with inflammatory bowel disease.European journal of clinical pharmacology · 2024Article
- Clinical Impact of Drug Adherence of Tyrosine Kinase Inhibitors in Children with Ph-Positive Acute Lymphoblastic Leukemia.Cancer research and treatment · 2023Article
- The impact of medication belief on adherence to infliximab in patients with Crohn's disease.Frontiers in pharmacology · 2023Article
- Multicenter Study of Nonadherence to Self-Injectable Biologic Therapy in Patients With Inflammatory Bowel Disease: Risk Factors and Outcomes.Gastro hep advances · 2023Article
- COVID-19 Pandemic Increased Anxiety Among Patients with Inflammatory Bowel Disease: A Patient Survey in a Tertiary Referral Center.Digestive diseases and sciences · 2022Article
- Medication adherence in women with IBD of childbearing age likely associated with disease knowledge.Therapeutic advances in gastroenterology · 2022Article
- Delaying an infliximab infusion by more than 3 days is associated with a significant reduction in trough levels but not with clinical worsening.Therapeutic advances in gastroenterology · 2022Article
- Sustained long-term benefits of patient support program participation in immune-mediated diseases: improved medication-taking behavior and lower risk of a hospital visit.Journal of managed care & specialty pharmacy · 2021Article
- Adherence to Adalimumab Was Not Improved by a Reminder-Based Intervention with an Electronic Needle Container.Digestive diseases and sciences · 2021Observational
- Chronic opioid use is associated with early biologic discontinuation in inflammatory bowel disease.Alimentary pharmacology & therapeutics · 2021Article
- Management of Crohn Disease: A Review.JAMA · 2021Review
- Pharmacist Interventions to Improve Specialty Medication Adherence: Study Protocol for a Randomized Controlled Trial.Drugs - real world outcomes · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesIn patients with inflammatory bowel disease (IBD) using biological therapy, non-adherence leads to anti-drug antibody formation and reduced effectiveness. Little is known about the optimal level of adherence in IBD patients on biologic therapy. We aimed to identify the association between adherence and disease flare and determine an optimal level of adherence.
methodsWe analyzed claims data for IBD patients prescribed adalimumab (ADA) and certolizumab (CZP) from the Truven Health MarketScan Commercial Claims and Encounters database from 2009 to 2013. Adherence was calculated using the medication possession ratio (MPR) from initiation until flare occurrence. A disease flare was defined as any hospitalization or new steroid prescription>90-days after drug initiation. The optimal MPR was determined using log-rank testing. The association between the optimal MPR and flare was assessed using multivariable Cox-Proportional hazards ratio.
resultsThere were 6,048 patients who were prescribed ADA (n=5,325) or CZP (n=723) for IBD. The average age was 41 years (±15) and 54% were female. The optimal MPR identified was 0.86 for ADA and 0.87 for CZP; 24% of the patients were below this level. Adjusting for age, gender, and concomitant medications at initiation, patients who were adherent above these levels had a 25% lower risk of flare for ADA (HR: 0.75, 95%CI: 0.67-0.83, P<0.01) and 41% lower risk for CZP (HR: 0.59, 95%CI: 0.46-0.76, P<0.01).
conclusionsPatients who delay refills >2 days on average every 2 weeks of their subcutaneous biologics have significantly increased risk of flare. Further studies to improve adherence among those patients who consistently delay medication use are necessary.
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