TOPLINE:

In patients with inflammatory bowel disease (IBD), biologic treatment demonstrated strong 12‑month persistence, with levels of a disease activity marker declining over time.

METHODOLOGY:

• Researchers conducted a retrospective study in Germany and analysed 587 adult patients with IBD (median age, 44 years; 53% women), including 312 with Crohn's disease and 275 with ulcerative colitis (UC), to examine drug persistence rates in biologic‑naive and biologic‑experienced patients.
• The analysis focused on 280 patients who received at least one biologic treatment: infliximab (n = 93), adalimumab (n = 165), vedolizumab (n = 116), or ustekinumab (n = 62), with drug persistence documented at induction, 3 and 6 months, and 1 year.
• The primary objective was to assess 12-month persistence with the newly started biologic treatment.
• Faecal calprotectin was used as a parameter to assess disease activity; levels above 250 μg/g were defined as the discriminator between high and low disease activity.

TAKEAWAY:

• At 1 year, drug persistence rates were 77.4% for infliximab, 80.6% for adalimumab, 70.7% for vedolizumab, and 71% for ustekinumab. When used as first-line biologic therapy, ustekinumab and vedolizumab had the shortest median treatment durations — 787 and 756.5 days, respectively.
• TNF‑alpha inhibitors had the longest continuation time prior to a switch owing to the loss of response or adverse events compared with vedolizumab (adalimumab vs vedolizumab and infliximab vs vedolizumab; P < .001 for both).
• A higher persistence was noted for vedolizumab than for ustekinumab (P = .011) and infliximab (P = .004) when accounting for confounders.
• A significant decrease in faecal calprotectin levels was observed between baseline and 6‑month and 1‑year timepoints. Faecal calprotectin levels were lower in patients with UC than in those with Crohn's disease (P = .044).

IN PRACTICE:

"Taken together, these findings highlight the complexity of evaluating biologic durability in real-world practice. While TNF-α [TNF-alpha] inhibitors appear most persistent when used as initial therapy, VDZ [vedolizumab] demonstrates superior persistence once patient characteristics and treatment histories are incorporated," the authors of the study wrote. "Importantly, our results demonstrate that existing therapies continue to offer effective and cost-efficient benefits and remain highly relevant, even with the emergence of IL [interleukin]-23 inhibitors," they added.

SOURCE:

This study was led by Karima Farrag, Goethe University Frankfurt, Frankfurt am Main, Germany. It was published online on December 17, 2025, in the Journal of Clinical Medicine.

LIMITATIONS:

Because the study was retrospective in nature, it may be subject to selection bias, which limited how widely the results can be applied. Data on endoscopic and histologic findings, disease activity scores, and reasons for stopping treatment were missing.

DISCLOSURES:

This study did not receive any external funding. Several authors reported receiving project funding and consulting, lecture, and speakers bureau fees from various pharmaceutical, biopharmaceutical, and biotechnology companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.