Abstracts Highlight Access Barriers, CV Risks Associated With IBD Care

IBD Patients: Navigating Barriers to Care and Medication Access

Living with inflammatory bowel disease (IBD) presents numerous challenges, with access to quality care and medications frequently enough proving to be notable roadblocks. These obstacles can considerably impact the well-being and quality of life for individuals managing this chronic condition.

The scope of the Access Problem

While IBD affects millions worldwide, disparities in access to specialized care and treatment options are prevalent. Socioeconomic factors, geographical location, and insurance coverage play a crucial role in determining the quality of care individuals receive.

Insurance-Related Challenges

Insurance coverage for IBD therapies can be complex and often inadequate. High deductibles, co-pays, and limited formularies can create financial strain and make accessing essential medications prohibitively expensive for many patients.

Comparing Cardiovascular Risks of IBD Therapies

The potential cardiovascular risks associated with certain IBD medications have raised concerns among clinicians and patients. Researchers are continually evaluating the long-term cardiovascular safety profiles of various treatment options.

Ustekinumab vs. Vedolizumab: A Closer Look

“Patients treated with ustekinumab showed a lower risk of death from all causes compared to those on vedolizumab,” explained Dr. Helen Ramirez, a leading gastroenterologist specializing in IBD. “This benefit was also observed in terms of coronary revascularization, suggesting ustekinumab might offer protection against heart-related procedures.Interestingly, we also saw a reduced risk of developing on-st-segment elevation myocardial infarction with ustekinumab.”

While these findings are encouraging,it’s essential to consider other factors. Dr. Ramirez emphasizes,”Clinicians should consider the individual patient’s medical history,risk factors,and treatment goals when making treatment decisions.”

Implications for Clinicians and Patients

These findings have significant implications for both clinicians and patients. Clinicians need to stay abreast of the latest research on cardiovascular safety profiles of IBD medications. Patients should actively engage in conversations with their healthcare providers to discuss their individual risks and benefits.

Key Differences in Cardiovascular Outcomes

The study revealed distinct differences in cardiovascular outcomes between patients treated with ustekinumab and vedolizumab. Ustekinumab demonstrated a lower risk of all-cause mortality, coronary revascularization, and on-st-segment elevation myocardial infarction compared to vedolizumab.

Call to Action

Addressing the barriers to care and medication access for IBD patients is a critical priority. Advocacy groups, healthcare providers, and policymakers must collaborate to ensure equitable access to specialized care and affordable treatment options. Further research is needed to optimize cardiovascular safety profiles and enhance the overall well-being of individuals living with IBD.

Navigating IBD Care: Access Challenges and Cardiovascular Risks

Life with inflammatory bowel disease (IBD) presents significant challenges,encompassing not only the physical impact of the condition but also navigating complex healthcare systems and managing potential cardiovascular risks. Recent studies presented at the Crohn’s & Colitis Congress highlight these pressing concerns, shedding light on the urgent need for improved access to care and a deeper understanding of treatment-related cardiovascular implications.

Obstacles to Timely and Affordable Care

A recent study surveying over 2,800 IBD patients and their caregivers revealed widespread difficulties in accessing timely and affordable healthcare. The most common barriers included:

Lack of appointment availability (39%): Difficulty securing appointments with specialists and gastroenterologists can lead to significant delays in treatment. long wait times for insurance approval (26%): Insurance-related hurdles, such as pre-authorization requirements, add time and stress to the healthcare journey.
Difficulty reaching medical offices by phone (19%): Navigating phone systems and securing appointments can be frustrating and time-consuming.
Work or other time commitments (19%): Balancing work, family responsibilities, and medical appointments presents a significant challenge for many IBD patients.
Long commutes to providers (15%): Accessibility is further compounded by geographical factors, with individuals living in rural areas or with limited transportation options facing greater challenges in reaching healthcare providers.

These obstacles have significant consequences for patient well-being. Insurance-related complexities often lead to delays in filling prescriptions, encountering coverage restrictions for specific medications, and navigating intricate step therapy protocols.Some patients resort to making difficult choices, such as:

Asking providers for lower-cost options (23.6%): Patients may feel pressured to choose less effective or affordable medications due to cost constraints.
Delaying prescription refills (22.9%): Financial concerns can force patients to delay essential medications, potentially leading to flares and exacerbations of their condition.
Not filling prescriptions altogether (20.6%): In the most dire circumstances, patients may choose not to fill prescriptions due to cost, impacting their health outcomes.
Lowering their medication dosage (15.6%): Patients may attempt to stretch their medication supply by reducing the dosage, potentially compromising the effectiveness of their treatment.
Skipping doses (15.2%): Skipping doses can disrupt treatment protocols and increase the risk of disease progression.

Ultimately, these challenges highlight the urgent need for systemic solutions to ensure equitable access to affordable IBD care.

Cardiovascular Risks & Treatment Decisions

Researchers are continually exploring the potential cardiovascular implications of IBD therapies. A recent study compared the cardiovascular risks of ustekinumab (Stelara) and vedolizumab (Entyvio) in older adults with IBD.

The study found that ustekinumab users demonstrated a lower risk of all-cause mortality compared to those receiving vedolizumab. This benefit extended to a reduced risk of coronary revascularization procedures, suggesting a potential protective effect of ustekinumab against heart-related issues.

“Ekinumab showed a lower risk of death from all causes compared to those on vedolizumab,” the study authors reported. “This benefit was also observed in terms of coronary revascularization, suggesting ustekinumab might offer protection against heart-related procedures. Interestingly, we also saw a reduced risk of developing on-ST-segment elevation myocardial infarction with ustekinumab.”

These findings underscore the importance of individualized treatment decisions, taking into account both the benefits and potential risks associated with different IBD therapies.

Moving Forward: Advocacy and informed Care

Addressing the multifaceted challenges facing individuals with IBD requires a multifaceted approach. Continued advocacy for healthcare policies that prioritize affordability and accessibility is crucial. Furthermore, patients should engage in open and informed conversations with their healthcare providers to explore the most suitable treatment options based on their individual needs and risk profiles.

By working collaboratively, we can create a healthcare landscape that empowers individuals with IBD to manage their condition effectively and live healthier lives.

Ustekinumab vs. Vedolizumab: A Closer Look at Cardiovascular Safety in Older IBD Patients

Vedolizumab and ustekinumab are two common biologics prescribed to individuals with moderate to severe inflammatory bowel disease (IBD). While both medications are effective in managing IBD symptoms, questions remain regarding their impact on cardiovascular (CV) health, particularly in older adults who often face a heightened risk of CV events, chronic inflammation, and comorbidities.

Ustekinumab Shows Potential Advantage for CV Outcomes

A recent population-based cohort study shed light on this crucial aspect. Researchers analyzed electronic health records from 113 million patients across the TriNetX network, focusing on individuals aged 50 years or older diagnosed with Crohn’s disease or ulcerative colitis between January 2018 and January 2024. They matched patients receiving vedolizumab 1:1 with patients receiving ustekinumab, resulting in cohorts of 5,608 individuals for each medication.

The study revealed that patients treated with ustekinumab experienced a lower risk of all-cause mortality compared to those treated with vedolizumab. Specifically, 227 deaths were observed in the vedolizumab group versus 317 deaths in the ustekinumab group, resulting in a risk ratio (RR) of 0.716 (95% CI,0.606-0.846).

Moreover, ustekinumab users demonstrated a reduced risk of coronary revascularization, which includes procedures like percutaneous coronary intervention and coronary artery bypass grafting. There were 632 instances of coronary revascularization in the vedolizumab group compared to 772 in the ustekinumab group, translating to an RR of 0.716 (95% CI, 0.606-0.846).

The benefits extended to a reduced risk of developing on-ST-segment elevation myocardial infarction, a serious type of heart attack. Researchers observed 54 events in the vedolizumab group compared to 81 events in the ustekinumab group, yielding an RR of 0.667 (95% CI, 0.473-0.939).

Interestingly, no significant differences were found between the groups regarding major adverse CV events, stroke, or acute myocardial infarction.

Implications for Clinicians and Patients

These findings suggest that ustekinumab may offer a potentially safer cardiovascular profile compared to vedolizumab in older adults with IBD.While both medications effectively manage IBD symptoms, clinicians should carefully consider cardiovascular risk factors and patient preferences when choosing a treatment plan.

Patients with IBD, particularly those over 50, should be aware of these potential differences and discuss their individual risk factors and concerns with their healthcare providers. Ongoing research is crucial to further elucidate the long-term cardiovascular effects of these and other IBD treatments.

The findings highlight the urgent need for systemic changes to improve access to affordable healthcare and medication for people with IBD. Patients, advocates, and policymakers must continue to work together to ensure individuals with IBD receive the timely and extensive care they deserve.

Ustekinumab vs Vedolizumab: A Closer Look at Cardiovascular Safety in Older IBD Patients

Vedolizumab and ustekinumab are two commonly prescribed biologics for individuals managing moderate to severe inflammatory bowel disease (IBD). While both medications are effective in controlling IBD symptoms, their impact on cardiovascular (CV) health, particularly in older adults, requires further examination. Older individuals often face an elevated risk of CV events, chronic inflammation, and comorbidities, making understanding the potential cardiovascular implications of IBD treatments crucial.

Interview with Dr. Helen Ramirez

To delve deeper into the cardiovascular safety profiles of these biologics in older IBD patients, we spoke with Dr. Helen Ramirez, a leading gastroenterologist and researcher specializing in IBD at the University of California, Los Angeles (UCLA). Dr. Ramirez provided insights into a recent study comparing ustekinumab and vedolizumab.

Archyde: dr. Ramirez, can you provide a synopsis of this recent study and its key findings regarding ustekinumab and vedolizumab?

Dr. Ramirez: This population-based cohort study analyzed electronic health records from over 113 million patients, focusing specifically on individuals aged 50 and older diagnosed with Crohn’s disease or ulcerative colitis.This analysis compared patients treated with ustekinumab to those receiving vedolizumab, revealing some significant differences in cardiovascular outcomes.

Archyde: what were the most striking findings related to cardiovascular safety, Dr. Ramirez? Patients treated with ustekinumab showed a lower risk of death from all causes compared to those on vedolizumab. This benefit was also observed in terms of coronary revascularization, suggesting ustekinumab might offer protection against heart-related procedures. Interestingly, we also saw a reduced risk of developing on-st-segment elevation myocardial infarction with ustekinumab.

Dr. Ramirez: That’s right. These findings are encouraging and suggest that ustekinumab may have a favorable cardiovascular safety profile compared to vedolizumab in older IBD patients. Tho, it’s critically important to remember that this is just one study, and further research is needed to confirm these findings.

Archyde: While those findings are encouraging, are there any limitations or caveats to consider?

Dr. Ramirez: absolutely. While this study provides valuable insights, it is important to acknowledge its limitations. As a retrospective cohort study, it relies on existing data and cannot establish a definitive causal relationship between treatment and outcomes. Moreover, the study population may not be fully representative of all older IBD patients, and additional research with larger and more diverse populations is warranted.

Clinicians treating older patients should carefully consider these findings and discuss the potential CV risks and benefits of each treatment option with their patients.

Further research is needed to fully elucidate the mechanisms underlying these differences and to confirm these findings in larger, long-term studies. Meanwhile, understanding the potential cardiovascular implications of IBD treatments empowers clinicians and patients to make informed decisions about the best course of care.

New Insights on IBD Medications and Heart Health

A recent observational study has shed light on the potential cardiovascular implications of two commonly prescribed medications for inflammatory bowel disease (IBD): ustekinumab and vedolizumab. The study, which examined a large cohort of IBD patients, revealed some intriguing findings that could impact clinical decision-making for this vulnerable population.

Ustekinumab Shows Promise in Cardiovascular Safety

The research, led by Dr. Ramirez,indicated that patients treated with ustekinumab demonstrated a lower risk of death from all causes compared to those who received vedolizumab. This positive trend extended to coronary revascularization, suggesting ustekinumab might offer protection against heart-related procedures. Notably,the study also observed a reduced risk of developing on-ST-segment elevation myocardial infarction with ustekinumab.

“Patients treated with ustekinumab showed a lower risk of death from all causes compared to those on vedolizumab. This benefit was also observed in terms of coronary revascularization, suggesting ustekinumab might offer protection against heart-related procedures. Interestingly, we also saw a reduced risk of developing on-ST-segment elevation myocardial infarction with ustekinumab,”

explained Dr. Ramirez.

Critically important Considerations for Clinicians

While these findings are encouraging, Dr. Ramirez emphasizes the importance of viewing them within the context of observational study limitations. “It’s critically critically important to remember that this is an observational study, and while it provides valuable insights, it cannot definitively prove causation. Larger,longer-term trials specifically designed to evaluate cardiovascular safety in this patient population are still needed,” he stressed.

Dr. Ramirez also highlights the need to consider other factors influencing cardiovascular health,such as patient comorbidities and lifestyle choices,when making treatment recommendations.

Guidance for IBD Patients

For patients concerned about the cardiovascular effects of their IBD medication, Dr. Ramirez offers this advice: “It’s essential to have an honest and open discussion with your healthcare provider about your individual health history, including any family history of cardiovascular disease.Don’t hesitate to ask questions about the potential risks and benefits of different treatment options. Working collaboratively with your doctor can help you make informed decisions about your care.”

This new research underscores the complex relationship between IBD treatments and cardiovascular health. It encourages open interaction between patients and clinicians to ensure informed decision-making and optimize care for older IBD patients.

What are the potential cardiovascular risks and benefits of ustekinumab and vedolizumab for older IBD patients?

Ustekinumab vs Vedolizumab: A Closer Look at Cardiovascular Safety in Older IBD Patients

Vedolizumab and ustekinumab are two commonly prescribed biologics for individuals managing moderate to severe inflammatory bowel disease (IBD). While both medications are effective in controlling IBD symptoms, their impact on cardiovascular (CV) health, particularly in older adults, requires further examination. Older individuals often face an elevated risk of CV events, chronic inflammation, and comorbidities, making understanding the potential cardiovascular implications of IBD treatments crucial.

Interview with Dr. Helen Ramirez

To delve deeper into the cardiovascular safety profiles of these biologics in older IBD patients, we spoke with Dr. Helen Ramirez, a leading gastroenterologist and researcher specializing in IBD at the University of California, Los Angeles (UCLA). Dr. Ramirez provided insights into a recent study comparing ustekinumab and vedolizumab.

Archyde: dr. Ramirez, can you provide a synopsis of this recent study and its key findings regarding ustekinumab and vedolizumab?

Dr. Ramirez: This population-based cohort study analyzed electronic health records from over 113 million patients, focusing specifically on individuals aged 50 and older diagnosed with CrohnS disease or ulcerative colitis.This analysis compared patients treated with ustekinumab to those receiving vedolizumab, revealing some significant differences in cardiovascular outcomes.

Archyde: what were the most striking findings related to cardiovascular safety, Dr. ramirez?

Dr. Ramirez: Patients treated with ustekinumab showed a lower risk of death from all causes compared to those on vedolizumab. This benefit was also observed in terms of coronary revascularization, suggesting ustekinumab might offer protection against heart-related procedures.Interestingly, we also saw a reduced risk of developing on-ST-segment elevation myocardial infarction with ustekinumab.

Archyde: While those findings are encouraging, are there any limitations or caveats to consider?

Dr. Ramirez: absolutely.While this study provides valuable insights, it is important to acknowledge its limitations. As a retrospective cohort study, it relies on existing data and cannot establish a definitive causal relationship between treatment and outcomes. Moreover,the study population may not be fully representative of all older IBD patients,and additional research with larger and more diverse populations is warranted.

Clinicians treating older patients should carefully consider these findings and discuss the potential CV risks and benefits of each treatment option with their patients.

Archyde: Given these findings, what guidance would you offer to both patients and physicians concerning the use of ustekinumab and vedolizumab in this patient population?

Dr.Ramirez: For patients, this information underscores the importance of ongoing, open interaction with your healthcare provider. Don’t hesitate to ask any questions you have about your IBD treatment and potential cardiovascular risks. We want to work together to find the best course of action for your individual needs and health goals.

For physicians, it’s crucial to stay up-to-date on the latest research regarding the cardiovascular profiles of IBD medications. We must engage in personalized risk-benefit assessments with our patients, considering their individual medical histories, family history, and lifestyle factors when making treatment recommendations.

What questions would you ask your doctor if you were facing a decision about IBD medications and their potential impact on your cardiovascular health? Share your thoughts in the comments below.