ArticleTherapeutic advances in gastroenterology2026
Persistence of advanced therapies in patients with ulcerative colitis: real-world data from the nationwide CREdIT registry.
Article in Therapeutic advances in gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The expanding therapeutic landscape of ulcerative colitis (UC) introduces uncertainty regarding the optimal positioning of new agents. Objectives: This study aimed to compare the real-world persistence of advanced therapies for UC. Design: This observational cohort study used a population-based national registry of biologic and small-molecule therapies for inflammatory bowel disease, CREdIT, to identify patients treated with advanced therapy for UC. Methods: The primary outcome was treatment persistence - defined as time from therapy initiation to discontinuation or last follow-up, whichever occurred first - and was analysed using mixed-effects Cox models and inverse probability weighting. Persistence was assessed overall, in first-line therapy, and in second-line therapy after adalimumab or infliximab exposure. Results: We included 3718 observations from 2525 patients with UC (48% female). Infliximab (40%), vedolizumab (27%) and adalimumab (17%) were most frequently used. At 5 years, 1852 of 3718 observations (49.8%) remained on the same therapy. The treatment line alone was not associated with treatment persistence after accounting for patient-level clustering using a mixed-effects model. Vedolizumab showed significantly greater persistence than infliximab or adalimumab, including in first-line use. In second-line settings post-anti-tumour necrosis factor (TNF) exposure, upadacitinib had the highest persistence compared to tofacitinib, vedolizumab and ustekinumab, whereas vedolizumab was more persistent than tofacitinib. Conclusion: Vedolizumab demonstrated longer persistence than infliximab or adalimumab, regardless of treatment line. Following anti-TNF failure, upadacitinib showed the highest persistence.
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