Professor Universidade Federal do Recôncavo da Bahia (UFRB) Feira de Santana, Brazil
Background: Inflammatory bowel disease (IBD) prevalence has been growing worldwide, which generates a great demand for drugs essential for clinical remission and improving patient’s life quality. In Brazil, access to medicines for IBD treatment is provided free of charge by the Unified Health System (SUS, in Portuguese), playing an essential role in guaranteeing access to biological medicines for the treatment of IBD.
Objectives: To describe population characteristics and biologics use by patients with IBD in the Brazilian Northeast region.
Methods: Data from patients with IBD (Crohn's disease and ulcerative colitis) in the SUS Outpatient Information System (SIA/SUS, in Portuguese), an administrative database, between January 2008 and December 2021 were analyzed. Socioeconomic characteristics, IBD type, and medication used were analyzed. Absolute and relative frequencies were estimated for each variable per year. Proportions of biologics use were stratified by sex, age, and IBD type.
Results: In the analyzed period, 665,537 prescriptions for the treatment of IBD by the SUS were evaluated. The population of northeastern Brazil with IBD was mostly adults (81%), women (59.4%), brown/mixed (38.4%), and the more frequent IBD was ulcerative colitis (62.5%). Regarding pharmacotherapy, 86.8% of the prescriptions were of conventional synthetic drugs (azathioprine; ciclosporin; mesalazine; methotrexate; and sulfasalazine) and 13.2% of biological drugs (adalimumab; certolizumab pegol; infliximab; and vedolizumab). There was an increase in the use of biological drugs from 3.1% in 2008 to 15.9% in 2021. From 2008 to 2017, higher rates of infliximab prescription were found (3.1% to 7.6%), whereas higher rates of adalimumab prescription were observed from 2018 to 2021 (6.6% to 7.1%). The same pattern was observed in the stratified analyzes.
Conclusions: This study demonstrates an increase in biologics use through the years, possibly related to the better performance of these drugs in inducing and maintaining IBD remission. Furthermore, the increase in the use of adalimumab over infliximab in recent years may be associated with greater freedom caused by adalimumab
