Evidence map›Paper›PMID 40481399›Full record

ArticleBMC gastroenterology2025

Treatment sequences, outcomes, healthcare utilization, and costs in patients with inflammatory bowel diseases requiring advanced treatment-real world comparative effectiveness from German claims data.

Axel Dignass, Niels Teich, Stephan Kaiser, Juliane Sünwoldt, Christina Dünweber, Ines Weinhold, Julia Borchert, Robert Kudernatsch

Abstract readComparative Study
In one paragraph

Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Axel DignassAgaplesion Markus Krankenhaus, Medizinische Klinik I, Frankfurt/Main, Germany.
Niels TeichInternistische Gemeinschaftspraxis Für Verdauungs- und Stoffwechselkrankheiten, Leipzig, Germany.
Stephan KaiserTakeda Pharma Vertrieb GmbH & Co. KG, Berlin, Germany.
Juliane SünwoldtTakeda Pharma Vertrieb GmbH & Co. KG, Berlin, Germany.
Christina DünweberTakeda Pharma Vertrieb GmbH & Co. KG, Berlin, Germany.
Ines WeinholdWIG2 GmbH Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Germany. ines.weinhold@wig2.de.
Julia BorchertWIG2 GmbH Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung, Leipzig, Germany.
Robert KudernatschTakeda Pharma Vertrieb GmbH & Co. KG, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is limited data on inflammatory bowel disease advanced therapy sequences. Therefore, we examined real-world advanced therapy sequences to compare persistence, healthcare use and costs in first-line advanced therapy.

methodsEvaluable patient characteristics, treatments, sequences, and outcomes were extracted from the WIG2 claims benchmark database and observed from 2014 to 2021. Therapeutic effectiveness (persistence without discontinuation or inadequate response), healthcare resource utilization, and associated costs were analyzed. Advanced treatment group differences were adjusted by inverse probability weighting.

resultsTwo thousand nine hundred forty-eight patients with Crohn's disease or ulcerative colitis initiated at least one of the following advanced therapies during the study period: adalimumab (1,260), golimumab (111), infliximab (1,035), tofacitinib (17), ustekinumab (138) or vedolizumab (387). In patients with ulcerative colitis, vedolizumab as first-line advanced therapy demonstrated superior effectiveness in persistence without inadequate response over three years compared to infliximab (p < 0.05). Patients taking infliximab or ustekinumab had higher disease-related costs than those taking adalimumab, golimumab, tofacitinib or vedolizumab. In Crohn's disease patients, first-line treatment with adalimumab (p < 0.001), ustekinumab (p < 0.001) and vedolizumab (p < 0.017), showed superior persistence over 3 years compared to infliximab, and time to inadequate response was longer in patients taking adalimumab and vedolizumab (p < 0.001). Disease-specific treatment costs were lower in patients receiving adalimumab or vedolizumab as first-line advanced therapy. Compared to infliximab, patients treated with ustekinumab had significantly higher costs.

conclusionsAnti-TNF agents were most frequently used in first-line advanced therapy; however, vedolizumab appeared to be a preferred choice in terms of persistence and cost measures over three years from the start of treatment.

Indexed as

Colitis, UlcerativeCrohn DiseaseGastrointestinal AgentsHealth Care CostsInflammatory Bowel DiseasesPatient Acceptance of Health CareAdalimumabAdultAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedFemaleGermanyHumansInfliximabMaleMiddle AgedAdalimumabAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedGastrointestinal AgentsgolimumabInfliximabPiperidinesPyrimidinestofacitinibUstekinumabvedolizumabAdvanced therapy sequencingInflammatory bowel diseaseReal-world effectiveness

Identifiers

PMID40481399
PMCPMC12144843

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Registered trials

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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.