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The following is a summary of “Treatment sequences, outcomes, healthcare utilization, and costs in patients with inflammatory bowel diseases requiring advanced treatment—real world comparative effectiveness from German claims data,” published in the June 2025 issue of BMC Gastroenterology by Dignass et al. 

Researchers carried out a retrospective study to compare real-world treatment patterns, persistence, healthcare use, and associated costs among first-line advanced therapy sequences in patients with inflammatory bowel disease (IBD). 

They extracted evaluable characteristics, treatment details, sequences, and outcomes from the WIG2 claims benchmark database covering the period from 2014 to 2021 and analyzed therapeutic effectiveness, defined as persistence without discontinuation or inadequate response, along with healthcare resource utilization (HCRU), surgery, and related costs. The differences were adjusted between advanced treatment groups using inverse probability weighting (IPW).  

The results showed that 2,948 individuals with CD or ulcerative colitis (UC) initiated advanced therapy with adalimumab (ADA) (1,260), golimumab (GOL) (111), infliximab (IFX) (1,035), tofacitinib (TOF) (17), ustekinumab (UST) (138), or vedolizumab (VDZ) (387) during the study period. In UC, VDZ as first-line advanced therapy resulted in better persistence without inadequate response over 3 years compared to IFX (P< 0.05). Individuals on IFX or UST had higher disease-related costs than those on ADA, GOL, TOF, or VDZ. In CD, first-line use of ADA (P< 0.001), UST (P< 0.001), and VDZ (P< 0.017) showed improved 3-year persistence compared to IFX. Time to inadequate response (TTIR) was longer with ADA and VDZ (P< 0.001). Lower treatment-specific costs were observed with ADA and VDZ, while UST incurred significantly higher costs compared to IFX.  

Investigators concluded that although anti–tumor necrosis factor agents were most commonly used as first-line advanced therapy, VDZ showed greater persistence and more favorable cost outcomes over a 3-year period from treatment initiation. 

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-04022-7