P0787 - Reduction in Gastrointestinal Visits and Portal Messaging Following Tenapanor (IBSRELA) Initiation for Community Gastrointestinal Patients

Alan Fossa, PhD¹, Luisa Scott, PhD², Asma Khapra, MD³, Lavanya Viswanathan, MD, MS, FACG⁴, Kyle Staller, MD, MPH⁵
1Arbor Research Collaborative for Health, Ann Arbor, MI; 2Ardelyx, Inc., Waltham, MA; 3Gastro Health, Fairfax, VA; 4UT MD Anderson Cancer Center, Houston, TX; 5Massachusetts General Hospital, Boston, MA

Introduction: Irritable bowel syndrome with constipation (IBS-C) is a chronic disorder of gut-brain interaction (DGBI) associated with high healthcare resource utilization (HCRU). Tenapanor (TEN [IBSRELA]) is a first-in-class, minimally absorbed inhibitor of intestinal sodium/hydrogen exchanger isoform 3 approved for the treatment of IBS-C in adults. An electronic health records (EHR) study is ongoing to understand the real-world use and outcomes of IBS-C medications in community gastrointestinal (GI) practices. Here, we report findings for within-patient changes in GI-related HCRU following TEN initiation for the treatment of IBS‑C.

Methods: This observational study used EHR data from patients treated at a large medical group of approximately 350 gastroenterology providers serving over 6 million patients across 7 states. Eligible patients were aged ≥18 years, had a diagnosis of IBS, had ≥1 visit within the 365 days before initiating TEN, and initiated TEN ≥365 days prior to the EHR data pull. The within-patient change in clinical encounters and portal message activity was calculated by comparing utilization in the 365 days before versus after TEN initiation. Within-patient change in HCRU was stratified by tertile of pre-TEN HCRU.

Results: The study included 712 patients, of whom 86% were female, 44% were Medicare eligible, and the average age was 48 years. Overall, the median within-patient change in GI visits after TEN initiation was −1 (quartile [Q]1: −2, Q3: 0) for regular visits and 0 (Q1: −3, Q3: 1) for labs. High utilizers (≥4 pre-TEN clinical encounters) had substantial reductions in regular visits (median change: −3, Q1: −4, Q3: −2) and labs (median change: −4, Q1: −7; Q3: −3) after TEN (Figure). Portal message activity also decreased in high utilizers (≥10 portal messages or ≥606 message words): number of messages (median change: −6, Q1: −19, Q3: 2) and words in messages (median change: −531, Q1: −1059, Q3: 54)) (Figure). Changes in clinical encounters and portal message activity after TEN were limited among low and moderate utilizers (Figure).

Discussion: These preliminary findings indicate that GI-related clinical encounters and patient portal message activity substantially decreased after TEN initiation among patients with high pre-TEN HCRU in each category. This suggests that TEN may reduce burden on the healthcare system and patients by reducing high HCRU, potentially leading to cost savings.


Figure: Figure: Within-Patient Change in HCRU Before and After TEN Initiation by Tertiles of Utilization Over the 365 Days Before TEN

Disclosures:
Alan Fossa: Arbor Research Collaborative for Health – Grant/Research Support.
Luisa Scott: Ardelyx, Inc. – Employee.
Asma Khapra indicated no relevant financial relationships.
Lavanya Viswanathan: Ardelyx, Inc. – Advisor or Review Panel Member, The above are unpaid., Speakers Bureau.
Kyle Staller: Ardelyx – Grant/Research Support. Gemelli – Consultant. Laborie – Consultant. Mahana – Consultant. Salix – Consultant. Takeda – Expert witness.

Alan Fossa, PhD¹, Luisa Scott, PhD², Asma Khapra, MD³, Lavanya Viswanathan, MD, MS, FACG⁴, Kyle Staller, MD, MPH⁵. P0787 - Reduction in Gastrointestinal Visits and Portal Messaging Following Tenapanor (IBSRELA) Initiation for Community Gastrointestinal Patients, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.