Crohn's & Colitis 360最新文献

{"title":"Building a career in inflammatory bowel disease: strategies to identify and cultivate a niche.","authors":"Alvin T George, Hilary K Michel, Lisa B Malter","doi":"10.1093/crocol/otag029","DOIUrl":"10.1093/crocol/otag029","url":null,"abstract":"","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag029"},"PeriodicalIF":1.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes of prolonged induction or re-escalation dosing of upadacitinib in patients with inflammatory bowel disease.","authors":"Ellen Axenfeld, Vasantham Chaudhary, Joseph W Clinton, Michael Frohlinger, Lauren George, Raymond K Cross, Jordan E Axelrad","doi":"10.1093/crocol/otag021","DOIUrl":"10.1093/crocol/otag021","url":null,"abstract":"<p><strong>Background: </strong>Proposed treatment algorithms favor the use of upadacitinib in medically refractory Crohn's disease (CD) and ulcerative colitis (UC). There has not yet been data published regarding efficacy of prolonged induction in CD or the efficacy of re-escalation to induction dosing in patients with either CD or UC. The aim of this study was to evaluate the real-world efficacy and safety of prolonged and/or re-escalation upadacitinib therapy in patients with inflammatory bowel disease (IBD) and prior inadequate response to standard upadacitinib treatment.</p><p><strong>Methods: </strong>This was a retrospective, dual-center study of the efficacy of prolonged induction or re-escalation of upadacitinib in patients with IBD with prior inadequate response to standard upadacitinib treatment.</p><p><strong>Results: </strong>Fifty-five patients met eligibility criteria. Thirty-nine (70.9%) persisted on upadacitinib therapy while 16 (29.1%) met the primary endpoint for upadacitinib failure. Of those that had comparative objective data, 62.5% had improvement in endoscopic activity, 100% had normalization of an elevated CRP, and 83.3% experienced a decrease in FCP by >50%. There were no new safety signals.</p><p><strong>Conclusion: </strong>Over two-thirds of patients met the primary endpoint of persistence on therapy without requiring surgery, steroids, or additional biologic/small molecule inhibitor during follow-up. In a subset of patients who had adequate baseline and follow up objective data, the majority of patients had improvement in mucosal healing, decrease by 50% in FCP, and normalization of CRP. This study shows promising results that prolonged upadacitinib induction or dose re-escalation may improve clinical outcomes in a medically refractory patient population.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag021"},"PeriodicalIF":1.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal ultrasound in acute severe ulcerative colitis treated with intravenous cyclosporine: case series.","authors":"Yusuke Miyatani, Joëlle St-Pierre, Jeremy Klein, David T Rubin, Noa Krugliak Cleveland","doi":"10.1093/crocol/otag037","DOIUrl":"10.1093/crocol/otag037","url":null,"abstract":"<p><strong>Background: </strong>Intestinal ultrasound (IUS) has been studied to assess therapeutic response in patients with acute severe ulcerative colitis (ASUC). However, there is no data on sonographic changes occurring in ASUC receiving intravenous (IV) cyclosporine. This case series aims to describe the sonographic changes occurring in hospitalized patients with ASUC receiving IV cyclosporine as salvage therapy.</p><p><strong>Methods: </strong>This is a retrospective observational study in a single tertiary care center from February 2023 to May 2024. Serial sonographic findings of patients with severe UC treated with IV cyclosporine were collected. Sonographic changes associated with clinical outcomes were analyzed. Outcomes included clinical response (Simple Clinical Colitis Activity Index decrease of ≤3 at day 3 with discharge on oral cyclosporine) and colectomy.</p><p><strong>Results: </strong>Nine patients received IV cyclosporine with IUS monitoring; 67% failed ≥2 advanced therapies. Four responded to cyclosporine, four underwent colectomy, and one switched to upadacitinib with a subsequent response during the same admission. Clinical responders had a median 31.8% (IQR 26.3-51.2) reduction in bowel wall thickness (BWT) and 1-scale reduction in modified Limberg score, whereas non-responders demonstrated 7.2% (IQR 54.8-9.0) reduction in BWT and no change in modified Limberg score. The median time to clinical response was 2.5 days (IQR 1.8-2.6). Baseline BWT was similar between responders and non-responders: 5.2 mm (IQR 3.5-6.5) versus 5.2 mm (3.8-6.7).</p><p><strong>Conclusions: </strong>A median 31.8% BWT reduction was observed by day 3 among responders, highlighting early sonographic changes associated with response to IV cyclosporine therapy in refractory ASUC.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag037"},"PeriodicalIF":1.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in prevalence, screening, and complications of osteoporosis in patients with inflammatory bowel disease: a retrospective cohort study.","authors":"Benjamin Eric Hoffman, Jennifer Youn, Madeline Alizadeh, Tamiru Berake, Ki Jung Lee, Lisa Ceglia, Sonia Friedman","doi":"10.1093/crocol/otag032","DOIUrl":"10.1093/crocol/otag032","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis is a complication of inflammatory bowel disease (IBD) with an estimated prevalence of 18%-42%. Given the paucity of data, this exploratory study aims to identify racial differences in prevalence, screening, and complications of osteoporosis in patients with IBD.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted for patients with IBD and treated at Tufts Medical Center from January 1, 2010 to December 31, 2023. The rates of osteoporosis, osteopenia, and osteoporotic fractures were calculated and compared between White, Black, and Asian patients. Dual energy X-ray absorptiometry (DXA) screening rates were compared between the three races. Fisher's exact test was used to compare categorical variables, and Welch's t-test was used to compare quantitative data. Multivariable regression analysis was performed to assess the relationship between risk factors and the presence of osteoporosis, osteoporotic fractures, and cumulative events. Glucocorticoid exposure was defined as having had one or more glucocorticoid prescriptions during the study period.</p><p><strong>Results: </strong>A total of 2517 patients with IBD were identified. There were 175 (7.0%) Asian, 156 (6.2%) Black, and 2186 (86.8%) White patients. There were statistically higher rates of osteoporosis and osteoporotic fractures in Asian patients compared to Black and White patients, respectively; (17.1% vs. 10.9% vs. 9.8%, <i>P</i> = .013) and (10.9% vs. 5.1% vs. 6.0%, <i>P</i> = 0.049). Black patients had higher rates of glucocorticoid exposure compared to Asians and Whites (39.1% vs. 28.6% vs. 27.2%, <i>P</i> = 0.007). There were no statistically significant differences in DXA screening rates between races.</p><p><strong>Discussion: </strong>Asian populations with IBD were found to have higher prevalence of osteoporosis and osteoporotic fractures; these differences may reflect unmeasured genetic, environmental, or socioeconomic factors.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag032"},"PeriodicalIF":1.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational weight gain and birth outcomes in a large Canadian cohort of pregnant persons with inflammatory bowel disease.","authors":"Derek M Nguyen, Parul Tandon, Vivek Govardhanam, Youstina Hanna, Jessie J Tao, Julie Cepo, Cynthia Maxwell, Vivian W Huang","doi":"10.1093/crocol/otag040","DOIUrl":"10.1093/crocol/otag040","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant persons with inflammatory bowel disease (IBD) are at increased risk of preterm delivery. We sought to characterize gestational weight gain (GWG) in this population and whether it is associated with birth outcomes.</p><p><strong>Methods: </strong>Pregnant patients with ulcerative colitis (UC), Crohn's disease (CD), and IBD-unclassified (IBD-U) were retrospectively identified at Mount Sinai Hospital from 2016 to 2020. Total GWG during pregnancy was categorized as inadequate, adequate, or excessive based on pre-pregnancy body mass index. Birth outcomes, including preterm delivery, small for gestational age (SGA), and large for gestational age, were recorded. Outcomes were compared among GWG groups. The association between GWG and outcomes was assessed using multiple logistic regression while controlling for confounders.</p><p><strong>Results: </strong>Two-hundred and twenty-five pregnancies were included (110 UC/IBD-U and 115 CD). The proportion of patients with inadequate, adequate, and excessive GWG was 21.3%, 40.4%, and 38.2%, respectively. The likelihood of preterm delivery did not differ among those with inadequate, adequate, and excessive GWG. The likelihood of SGA was lower in those with excessive GWG compared with those with inadequate and adequate GWG (7% vs 21% and 20%, respectively, <i>P</i> = .02). After adjusting confounders, the reduced odds of SGA associated with excessive GWG were only statistically significant among those with UC (adjusted odds ratio, 0.14; 95% CI: 0.03-0.74).</p><p><strong>Conclusions: </strong>Both inadequate and adequate GWG are common in pregnant persons with IBD. In our cohort, inadequate GWG was not associated with adverse birth outcomes, while excessive GWG appears to be protective against SGA.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag040"},"PeriodicalIF":1.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boosting mental health and quality of life for people living with inflammatory bowel disease using a mobile app and online health coaching.","authors":"Celeste M Lavallee, Natasha Haskey, Kevin McGregor, Munazza Yousuf, Simona Veniamin, Levinus A Dieleman, Puneeta Tandon, Lorian M Taylor, Maitreyi Raman","doi":"10.1093/crocol/otag041","DOIUrl":"10.1093/crocol/otag041","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel diseases (IBD) experience anxiety, depression, and decreased quality of life (QoL), even when in remission. Mobile health apps with online health coaching focusing on self-management could help reduce mental health burden and improve QoL.</p><p><strong>Methods: </strong>In this real-world, patient-centered study, patients with IBD chose conventional management (CM) alone or with the intervention (INT), which included the use of a mobile health app with online coaching. Changes in anxiety, depression, and QoL were assessed after 12 weeks using the Generalized Anxiety Disorder 7-item scale, the 9-item Patient Health Questionnaire, and the 12-item Short-Form Scale. Physical activity, stress, sleep, and diet were secondary outcomes.</p><p><strong>Results: </strong>Of 65 adult participants, 45 (14 with ulcerative colitis and 31 with Crohn's disease) completed the study; 21 in the CM group and 24 in the INT group. In the INT compared to CM group from baseline to week 12, the risk of anxiety decreased (<i>P</i> = .002) and QoL improved (<i>P</i> <.001 and <i>P</i> = .007 for physical and mental health summary scores, respectively). Risk of depression decreased significantly in both groups, but not between groups (<i>P</i> = .28). Physical activity, stress, and sleep significantly improved within both groups, but changes were not significant between groups. The INT group increased intakes of vitamin C, folate, total fruit, and legumes by a greater magnitude than the CM group (<i>P</i> < .04).</p><p><strong>Conclusions: </strong>Integrating a mobile app with online health coaching into IBD management is an effective strategy for improving mental health and QoL.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag041"},"PeriodicalIF":1.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The UCEIS and UC-100 score were responsive endoscopic and global indices in a phase 2 trial of ulcerative colitis.","authors":"Sudheer K Vuyyuru, Simon Travis, Soushyant Kiarasi, Guangyong Zou, Stephen Lagana, David F Schaeffer, Vipin Arora, Jay L Tuttle, Christopher Ma, Vipul Jairath","doi":"10.1093/crocol/otag031","DOIUrl":"10.1093/crocol/otag031","url":null,"abstract":"<p><strong>Background: </strong>Trials evaluating ulcerative colitis (UC) therapies necessitate instruments that are responsive to changes in disease status. We assessed responsiveness of the Mayo Endoscopic Subscore (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), Robarts Histopathology Index (RHI), Geboes Score (GS), Nancy Histological Index (NHI), and UC-100 score.</p><p><strong>Methods: </strong>Using data from a phase 2 placebo-controlled trial of mirikizumab, responsiveness was quantified by the probability that a patient in the treatment group would have a better score than (win over) a control patient. Inference on win probability (WinP) was conducted without normality assumption of scores. Spearman rank correlations between each index and stool frequency (SF), rectal bleeding (RB), fecal calprotectin (FCAL), and C-reactive protein (CRP) were assessed.</p><p><strong>Results: </strong>WinP estimates showed that magnitudes of responsiveness were \"medium\" for the UCEIS (0.67; 95% CI 0.59, 0.74) and UC-100 score (0.68; 95% CI 0.60, 0.75) and \"small\" for the RHI (0.62; 95% CI 0.54, 0.70), MES (0.61; 95% CI 0.53, 0.68), and GS (0.60; 95% CI 0.52, 0.68). The NHI showed no statistical evidence of responsiveness (0.57; 95% CI 0.48, 0.65). The UCEIS and MES had weak-to-moderate correlations with SF (0.21-0.26) and RB (0.29-0.33) but no correlation with biomarkers. The UC-100 had moderate correlations with RB (0.46) and FCAL (0.42) and weak correlation with CRP (0.19).</p><p><strong>Conclusions: </strong>The UCEIS and UC-100 score were responsive to changes in endoscopic and global UC disease activity, respectively. Results may help inform future early phase UC drug trials but should be confirmed in larger studies.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag031"},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, age-distribution, and impact on management of acne in patients on upadacitinib for inflammatory bowel disease: insights from a single-center survey.","authors":"Elizabeth A Spencer, Matthew Smyth, Ahuva Cices, Alana Mercurio, Drew Helmus, Ryan C Ungaro, Marla C Dubinsky","doi":"10.1093/crocol/otag036","DOIUrl":"10.1093/crocol/otag036","url":null,"abstract":"<p><strong>Background: </strong>Upadacitinib (UPA), an oral JAK1 inhibitor, has been associated with acne in up to 7% of patients with inflammatory bowel disease (IBD) in clinical trials. Emerging real-world evidence suggests the true prevalence may be higher, particularly among adolescents and young adults. This study evaluated the prevalence, age distribution, and impact of UPA-associated acne on treatment decisions in a real-world IBD cohort.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted within a prospective IBD BioBank at a tertiary care center. All patients currently or previously treated with UPA (<i>n</i> = 110) were invited to complete a 22-item electronic survey assessing acne history before and after UPA initiation, acne severity, treatments used, awareness of acne as a side effect, and influence on medication management.</p><p><strong>Results: </strong>The survey was completed by 100 patients (91% response rate); 54% had Crohn's disease and 46% ulcerative colitis. The median age was 23 years (IQR 18-35, range 7-66). Prior to UPA, 25% reported acne, predominantly mild. After starting UPA, 48% experienced new or worsening acne; 38% reported it as moderate, 29% as severe, and 46% sought dermatologic care. At the time of the survey (median 458 days), 52% continued to have acne, well-controlled in only ¼ with treatment; 5% had discontinued UPA due to acne. While 80% felt the benefits of UPA outweighed acne-related concerns, 7% disagreed-despite most achieving clinical remission. Acne was significantly less prevalent at the extremes of age, <13 and >50 (<i>P </i>= .003).</p><p><strong>Conclusion: </strong>Acne is a frequent and sometimes treatment-limiting side effect of UPA. Targeted counseling may support adherence.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag036"},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary biomarkers of urolithiasis risk in Crohn's disease: hyperoxaluria, hypocitraturia, and hypomagnesuria in patients with and without ileocolic resection.","authors":"Vit Navratil, Barbora Pipek, Premysl Falt, Jana Zapletalova, Jan Krivinka, Virginia Solitano, Lumir Kunovsky","doi":"10.1093/crocol/otag033","DOIUrl":"10.1093/crocol/otag033","url":null,"abstract":"<p><strong>Background/aims: </strong>Patients with Crohn's disease (CD) are at an increased risk of urolithiasis, particularly after ileocolic (IC) resection. This study aimed to investigate the prevalence of hyperoxaluria, hypocitraturia, and hypomagnesuria in CD patients with and without IC resection, compared to healthy controls.</p><p><strong>Methods: </strong>This cross-sectional study included three groups: CD patients who had undergone IC resection (group 1), CD patients with IC involvement but without active inflammation and without resection (group 2), and healthy controls (group 3). Each participant collected a 24-hour urine sample for analysis of oxalate, citrate, and magnesium excretion.</p><p><strong>Results: </strong>A total of 107 participants were enrolled (34 in group 1, 42 in group 2, and 31 in group 3). The prevalence of hyperoxaluria was 26.5% in group 1, 35.7% in group 2, and 29.0% in group 3, with no significant differences between groups (<i>P</i> = .664). Hypocitraturia was more common in CD groups: 35.3% in group 1, 31.0% in group 2, compared to 9.7% in controls, with a significant difference from controls (<i>P</i> = .034). A significant difference in hypomagnesuria was found in group 1 compared to groups 2 and 3 (<i>P</i> = .001).</p><p><strong>Conclusion: </strong>While hyperoxaluria prevalence was similar across groups, hypocitraturia and hypomagnesuria were more frequent in CD patients, particularly those with IC resection. Monitoring these biomarkers may help identify at-risk individuals and guide prevention of urolithiasis in CD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag033"},"PeriodicalIF":1.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced therapy treatment patterns in moderate-to-severe ulcerative colitis: a long-term retrospective claims analysis.","authors":"Parambir S Dulai, Christopher J Rabbat, Ian Nason, Yechu Hua, Sydney Ng, Yixin Yang, Noam Kirson, Jennifer T Fine","doi":"10.1093/crocol/otag035","DOIUrl":"10.1093/crocol/otag035","url":null,"abstract":"<p><strong>Background: </strong>There has been significant evolution in advanced therapy (AT) options for moderate-to-severe ulcerative colitis (UC). We assessed shifts in treatment patterns over time using a large claims database with long-term follow-up.</p><p><strong>Methods: </strong>This retrospective study utilized the IQVIA PharMetrics Plus claims database (2012-2023) to analyze adults in the United States with UC who initiated an AT. Patients had ≥3 years of continuous follow-up after AT initiation and no evidence of other autoimmune diseases during the six-month baseline period. Treatment patterns including persistence, switching, and/or discontinuation were summarized. Analyses were stratified by year of AT initiation: 2012-2014, 2015-2016, 2017-2018, and 2019-2020.</p><p><strong>Results: </strong>6726 patients with a mean follow-up of 61.5 months and treatment duration of 22.9 months (SD: 14.2) were included. Vedolizumab usage increased over time in parallel with a reduction in anti-TNF therapy. Around 27%-34% of patients had dose escalation and 40% switched ATs at some point during follow-up. AT treatment persistence rates at 3 years of follow-up were <40% across all time periods, and <10% when limiting to patients who did not require dose escalation and/or steroids. Approximately 57% of patients in routine practice discontinued AT and did not start a subsequent AT.</p><p><strong>Conclusion: </strong>Despite the availability of multiple new AT options for UC, rates of steroid-free persistence without the need for dose escalation were low. High rates of treatment discontinuation across lines of therapy highlight a need for durable treatment options.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag035"},"PeriodicalIF":1.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}