OBJECTIVES: This study aims to examine real-world prescribing patterns of novel oral therapies in patients with ulcerative colitis (UC).

METHODS: This was a retrospective, longitudinal study using electronic health records between May 1^st, 2018, and December 31^st, 2022 from a large integrated delivery network. Patients were eligible for inclusion if they were 18 years old, had a diagnosis of ulcerative colitis and had a prescription from a gastroenterologist for one of the following medications: tofacitinib citrate, upadacitinib, or ozanimod hydrochloride. The index date was defined as the first date of an eligible prescription. A pre-treatment period of one year before the index date and a post treatment period of one year after the treatment end date were utilized. The primary outcome was to assess utilization of novel oral therapies. Secondary outcomes included assessing discontinuation rates, and treatment sequencing. Descriptive statistics were used to analyze the results.

RESULTS: Of the 71 patients (mean age, 38 years old; 32 [45.1%] female) with UC, 50 patients (64.3%) were prescribed tofacitinib citrate, 22 patients (28.6%) prescribed upadacitinib, and 6 patients (7.1%) prescribed ozanimod hydrochloride. 30 prescription records (38.5%) exceeded a total duration of therapy greater than 365 days. Prior to initiation of novel oral therapies, 26.7% of patients were on TNF-alpha inhibitors (TNFi), 22.5% on DMARD’s, 12.7% on budesonide, and 38.1% were unknown. There were 39 cases of treatment discontinuation. 30.8% of patients switched to a TNFi, 10.3% to alternative JAK inhibitors, while 59.0% of patients had an unknown therapy change. The median time to treatment discontinuation was 257 days.

CONCLUSIONS: This is one of the few studies that examine prescribing patterns with novel small molecule therapies in UC. With the continuous advent of new therapies, future studies are needed to help optimize use in patients with UC.