Escalation to biologics after corticosteroids in patients with newly diagnosed Crohn's disease in Japan: a claims analysis from 2010 to 2021.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-07-01 Epub Date: 2025-11-25 DOI:10.5217/ir.2025.00059

Minoru Matsuura, Annabelle Yoon, Jun Miyoshi, Tadakazu Hisamatsu

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引用次数: 0

Abstract

Background/aims: A previous health insurance claims study of Japanese patients with newly diagnosed Crohn's disease (CD) reported an increase in "step-up" approach from 2010 to 2020, with biologic use in the first year remaining stable. This study examined systemic corticosteroid (SCS) use for newly diagnosed CD in Japan and compared patients who were escalated ("step-up") and were not escalated to biologics.

Methods: This retrospective longitudinal cohort study used health insurance claims data (JMDC database). Patients diagnosed with CD from 2010 to 2020 who had no CD-related claims for ≥ 1 year before index, were traceable for ≥ 1 year after index, and treated with ≥ 1 pre-defined treatment were included. Patients classified by SCS and/or biologic use within 1 year after diagnosis were compared.

Results: Of 823 patients, 379 (46.1%) received SCS in the first year; of these, 43.5% escalated to biologics (step-up group) and 56.5% did not (SCS group). The proportion of patients receiving SCS increased from 25.8% in 2010-2011 to 55.5% in 2020; proportion escalated to biologics increased from 33.8% in 2016-2017 to 51.0% in 2020. The step-up group was significantly younger, more likely to have perianal lesions, and received more intensive treatments than the SCS group. In terms of SCS use, the step-up group was more likely to have shorter time-to-SCS initiation, and a higher initial SCS dose, than the SCS group.

Conclusions: Escalation from SCS to biologics in Japanese patients with newly diagnosed CD increased between 2016 and 2020, particularly in patients with younger onset CD or perianal complications.

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日本新诊断的克罗恩病患者在使用皮质类固醇后改用生物制剂：2010年至2021年的索赔分析

背景/目的：先前一项针对日本新诊断克罗恩病（CD）患者的健康保险索赔研究报告称，从2010年到2020年，“逐步”治疗方法的使用有所增加，第一年的生物治疗使用保持稳定。本研究调查了日本新诊断的乳糜泻的全身皮质类固醇（SCS）使用情况，并比较了升级（“升级”）和未升级到生物制剂的患者。方法：采用健康保险索赔数据（JMDC数据库）进行回顾性纵向队列研究。纳入2010年至2020年诊断为CD的患者，这些患者在索引前≥1年没有CD相关的索赔，在索引后≥1年可追溯，并且接受了≥1种预定义治疗。比较诊断后1年内以SCS和/或生物制剂分类的患者。结果：在823例患者中，379例（46.1%）在第一年接受了SCS；其中，43.5%升级为生物制剂（强化组），56.5%未升级为生物制剂（SCS组）。接受SCS的患者比例从2010-2011年的25.8%增加到2020年的55.5%；升级为生物制剂的比例从2016-2017年的33.8%上升到2020年的51.0%。与SCS组相比，强化组明显更年轻，更容易发生肛周病变，接受更强化的治疗。在SCS使用方面，与SCS组相比，强化组更可能具有更短的起始时间和更高的初始SCS剂量。结论：在2016年至2020年期间，日本新诊断的CD患者从SCS到生物制剂的升级增加，特别是在发病较年轻的CD患者或肛周并发症患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.