A comparative analysis of persistence of advanced therapies among patients with inflammatory bowel disease in Taiwan.

Abstract

Background/aims: The prevalence of inflammatory bowel disease (IBD) is rising in Asia. Advanced therapies, defined as biologics and small-molecule drug used for IBD treatment, have improved outcomes for moderate to severe IBD, making treatment selection critical. This is the first study in Taiwan comparing real-world persistence rates of advanced therapies in IBD patients in Taiwan.

Methods: A retrospective cohort study was conducted on 511 IBD patients from Linkou Chang Gung Memorial Hospital between October 2017 and January 2024. The five therapies evaluated were infliximab (IFX), adalimumab (ADA), vedolizumab (VDZ), ustekinumab (UST), and tofacitinib (TOF). Persistence within 52 weeks was assessed for biologic-naïve and biologic-experienced IBD patients.

Results: Of the 511 patients, 210 had ulcerative colitis (UC) and 301 had Crohn's disease (CD). UST showed the highest 52-week persistence in CD (91.08 %), followed by ADA (81.94 %), IFX (73.76 %), and VDZ (64.35 %), with a statistically significant difference (p < 0.001). In UC, UST also had the highest persistence rate (78.95 %), though this did not reach statistical significance (p = 0.083). IFX had the highest discontinuation rate due to side effects (5.9 %) CONCLUSIONS: UST showed superior 52-week persistence in CD patients, though it also had the highest rate of dose escalation. IFX had the highest rate of discontinuation due to side effects.