Treatment patterns and determinants of persistence with advanced therapies in adults with newly diagnosed Crohn’s disease: an interim analysis of an inception cohort registry study (iCREST-CD)
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND AIMS: Multiple advanced therapies are available for the treatment of Crohn's disease (CD). Treatment patterns in newly diagnosed patients and the factors associated with persistence remain unclear. We present interim results of the iCREST-CD registry describing treatment patterns and persistence with advanced therapies. METHODS: Patients aged ≥16 years with newly diagnosed CD and who had no prior exposure to advanced therapies were enrolled. Persistence of advanced therapies was estimated using Kaplan-Meier analyses, and associated factors were identified using multivariable Cox proportional hazards models. Persistence was also compared between patients who initiated therapy early or later after diagnosis. RESULTS: Of 672 patients (68.2% male; mean age 29.4 ± 13.1 years), 498 (74.1%) initiated advanced therapy: infliximab (IFX; 121), adalimumab (ADA; 244), ustekinumab (UST; 107), or vedolizumab (VDZ; 26). Advanced therapy was initiated within 1 year of diagnosis in 404 (60.1%). The 36-month treatment persistence rates for IFX, ADA, UST, and VDZ were 77.5%, 75.7%, 79.8%, and 49.0%, respectively. After propensity score adjustment using inverse probability of treatment weighting, the early initiation was associated with greater persistence than delayed initiation, although the difference did not reach statistical significance (hazard ratio, 0.61; 95% confidence interval, 0.35-1.09; P = .067). CONCLUSIONS: A high prevalence of early advanced therapy use and a high level of persistence with first-line advanced therapy were identified in this national cohort. Early initiation was associated with greater treatment persistence than delayed initiation, suggesting the potential clinical relevance of earlier advanced therapy use in routine practice. These findings require confirmation in other prospective studies aiming to evaluate early intervention strategies. REGISTRATION: The study was registered with the University Hospital Medical Information Network Clinical Trials Registry (umin.ac.jp/ctr Identifier: UMIN000032237) prior to initiation.
Source: Journal of Crohn s and Colitis
Authors: Shinichiro Shinzaki, Katsuyoshi Matsuoka, Toshimitsu Fujii, Ryuichi Okamoto, Akihiro Yamada, Reiko Kunisaki, Minoru Matsuura, Kenji Watanabe, Hisashi Shiga, Noritaka Takatsu, Shigeki Bamba, Yohei Mikami, Takayuki Yamamoto, Takahiro Shimoyama, Satoshi Motoya, Takehiro Torisu, Taku Kobayashi, Naoki Ohmiya, Masayuki Saruta, Koichiro Matsuda, Takayuki Matsumoto, Hiroshi Nakase, Atsuo Maemoto, Shinichi Yoshigoe, Hiroaki Tsuchiya, Akiko Hori-Nishi, Tadakazu Hisamatsu, iCREST-CD Study Group, Masakazu Nagahori, Daisuke Saito, Mikio Kawai, Atsushi Masamune, Mitsuo Nagasaka, Tomoe Kazama
Institutions: Hyogo Medical University, Toho University, Toho University Medical Center Sakura Hospital, Institute of Science Tokyo, Yokohama City University Medical Center, Kyorin University, Toyama University Hospital, University of Toyama, Tohoku University, Fukuoka University, Shiga University of Medical Science, Keio University, Yokkaichi Social Insurance Hospital, Sapporo Kosei General Hospital, Kyushu University, Kitasato Institute Hospital, Kitasato University, Fujita Health University, Jikei University School of Medicine, Iwate Medical University, Sapporo Medical University, Sapporo Higashi Tokushukai Hospital, Janssen Pharmaceutical K.K. (Japan)
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
OpenAlex ID: W7225455672