OBJECTIVES: This study aimed to assess the treatment patterns for Ulcerative Colitis (UC) and Crohn's Disease (CD) patients in Taiwan, with a specific focus on targeted therapies (TTs) using Taiwan's National Health Insurance Research Database (NHIRD).

METHODS: We conducted a cross-sectional analysis from 2016 to 2020 annually and identified patients with catastrophic illness certificates issued for UC or CD. We described their treatment patterns, including the use of glucocorticoids, immunomodulators, TTs, and 5-aminosalicylic acid (5-ASA) therapies. Additionally, we conducted a subgroup analysis to show the evolution of treatment patterns of patients utilizing TTs.

RESULTS: For the general CD population, the most prevalent Line 1 treatments were 5-ASA therapies (80.17%) and glucocorticoid therapy (51.29%). Immunomodulator-based and TTs were employed by 38.79% and 3.45% of Line 1 therapy patients, respectively. In the UC population, 5-ASA therapy dominated, with 97.34% adoption, while other therapy classes were used by less than half of the patients. By 2020, TTs were used by 38.82% of CD patients and 15.48% of UC patients. This treatment mix of TT usage evolved over time for CD patients, with adalimumab exclusively used in 2016, but by 2020, adalimumab represented 56.19% of choices, followed by vedolizumab (33.33%), infliximab (15.71%), and ustekinumab (3.02%). Among UC patients in 2016, TTs mainly consisted of adalimumab (78.26%) and golimumab (21.74%), but by 2020, vedolizumab had taken the lead (46.58%), followed by adalimumab (41.07%), golimumab (11.46%), and infliximab (8.48%). For both disease areas, adalimumab lost the greatest share and vedolizumab gained the greatest share of patients.

CONCLUSIONS: The study underscores the prevailing use of 5-ASA and other conventional therapies in both UC and CD populations, with limited adoption of TTs. The changing landscape of TT preferences over time suggests evolving treatment strategies for these chronic inflammatory conditions in Taiwan.