Observational studyClinical and translational gastroenterology2020
Treatment Pathways Leading to Biologic Therapies for Ulcerative Colitis and Crohn's Disease in the United States.
Observational study in Clinical and translational gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Efficacy and safety of the S1PR modulator etrasimod in the treatment of moderately to severely active ulcerative colitis during the induction phase: a systematic review and meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2024Pooled it
- Systematic review and meta-analysis: efficacy and safety of early biologic treatment in adult and paediatric patients with Crohn's disease.Alimentary pharmacology & therapeutics · 2020Pooled it
- Corticosteroid-sparing effects of risankizumab versus ustekinumab in patients with moderately to severely active Crohn's disease: post hoc results from the phase 3b SEQUENCE trial.Journal of Crohn's & colitis · 2026Trial
- Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.Alimentary pharmacology & therapeutics · 2023Trial
- STRIDE-II treatment target achievement in inflammatory bowel disease: a cross-sectional study from a tertiary IBD centre in the United Arab Emirates.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026Article
- Treatment and Outcomes of Crohn's Disease and Ulcerative Colitis in Newly Diagnosed Adults in the United States, 2007 to 2023.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Advanced therapy treatment patterns in moderate-to-severe ulcerative colitis: a long-term retrospective claims analysis.Crohn's & colitis 360 · 2026Article
- Study on the mechanism of action of HuaZhuoKeLi in modulating LCN2-mediated cellular pyroptosis to ameliorate ulcerative colitis.Scientific reports · 2026Article
- Redefining Early Intervention and the Window of Opportunity in Crohn's Disease.Gastroenterology & hepatology · 2026Article
- Patterns of conventional therapy use and advanced therapy initiation drivers in inflammatory bowel disease.Therapeutic advances in gastroenterology · 2026Article
- A decade of clinical data with vedolizumab: the past, present, and future.Therapeutic advances in gastroenterology · 2026Review
- The efficacy and safety of etrasimod as a first-line advanced therapy for ulcerative colitis: prespecified and post hoc subgroup data from the ELEVATE UC clinical program.Therapeutic advances in gastroenterology · 2026Article
- The outcome of Infliximab induction in patients with severe ulcerative colitis may be related to intestinal microbiota.Frontiers in microbiology · 2026Article
- Temporal Trends in Medical and Surgical Management of Ulcerative Colitis in England: 2003-2020.Alimentary pharmacology & therapeutics · 2026Article
- Assessment of PredictSURE IBD Assay in a Multinational Cohort of Patients With Inflammatory Bowel Disease.United European gastroenterology journal · 2025Article
- Disparities in Access and Treatment for Rural Patients With Inflammatory Bowel Disease: A Survey of Inflammatory Bowel Disease Patients and Providers.Inflammatory bowel diseases · 2025Article
- Long-Term Humoral Response to Hepatitis B Vaccination in Patients with Inflammatory Bowel Disease in Oman: Impact of Prednisolone and Esomeprazole as Contributing Factors.Oman medical journal · 2025Article
- Changes in Medical Management of Inflammatory Bowel Disease and Reducing Surgical Risk: Investigating Causality Through the Bradford-Hill Criteria.Journal of clinical medicine · 2025Review
- Commentary on the real-world effectiveness of vedolizumab in therapy-experienced ulcerative colitis: A response to Azzam et al .Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2025Article
- Health-care resource use and costs associated with inflammatory bowel disease in northwest London: a retrospective linked database study.BMC gastroenterology · 2024Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesBiologic therapies have been available for inflammatory bowel disease for >20 years, but patient outcomes have not changed appreciably over this time period. To better understand medication utilization for this disease, we evaluated a novel technique for visualizing treatment pathways, including initial treatment, switching, and combination therapies.
methodsThis retrospective, observational study used administrative claims data from the Truven Health MarketScan Commercial and Medicare Database. Adult patients with ≥2 consecutive health claims and newly diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) were evaluated. Treatment pathways were visualized using Sankey diagrams representing the number of patients receiving treatment and duration of each treatment.
resultsIn all, 28,119 patients with UC and 16,260 patients with CD were identified. The most common initial treatment for UC was 5-aminosalicylic acid monotherapy (61% of the patients), followed by corticosteroid monotherapy (25%); <1% of patients were initially treated with biologics. The most common initial treatment for CD was corticosteroid monotherapy (42%), followed by 5-aminosalicylic acid monotherapy (35%); <5% of the patients were initially treated with biologics. Significantly fewer patients followed biologic vs nonbiologic treatment pathways (UC: 6% vs 94%, CD: 19% vs 81%, both P < 0.05). DISCUSSION: Significantly fewer patients with inflammatory bowel disease followed treatment pathways that included biologic therapies compared with nonbiologic therapies, and very few patients were ever initiated on biologic therapy. Although we have made significant progress in treatment, our most effective medications are only being used in a small proportion of patients, suggesting barriers prevent optimized patient management.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.