Abstract Background With the approval of numerous new therapies for IBD in recent years, the sequence of treatments has become increasingly relevant. We analysed the course of therapy for IBD patients in the TARGET registry and calculated therapy switches (I) between modes of action (anti-TNF, VDZ, UST, IL-23, JAKi, S1P), (II) within the anti-TNF group, and (III) between biosimilars of IFX, ADA, and UST. Treatment persistence was compared between different modes of action. Methods The TARGET register is a prospective, multicenter, non-interventional cohort study collecting data on the effectiveness and safety of advanced therapies (ATs) in IBD patients throughout Germany. Data are collected every 6 months. These analyses examined data from 1764 patients enrolled in the TARGET registry between November 2019 and July 2025, including patients who initiated therapy prior to registry entry. Treatment persistence up to 10 years was analysed using Kaplan-Meier (KM) analysis with log-rank test to compare persistence curves between therapy groups. Chi2-test was used to compare final persistence rates. Results 2001 therapies (1216 in CD, 760 in UC) were available. Significant differences were observed in the proportion of bio-experienced patients ranged from 63–69% for ADA and GOL, and 87–92% for UST, JAKi, and IL-23. Glucocorticoids had been used by 80–100% of patients, and immunosuppressants by approx. 60% prior to registry entry. The proportion of patients who switched therapies ranged from 7-14% (Table 1). Patients treated with anti-TNF and VDZ predominantly switched to established therapies, whereas patients receiving other therapies switched more frequently to newer therapies (Table 1). Within the anti-TNF group, 17% of all switchers remained within the anti-TNF class, while 83% switched mode of action. Among IFX users, 15% patients switched between IFX biosimilars, while 1% switched to a different anti-TNF. In the ADA group, only 2% switched to an ADA biosimilar and 3% switched to IFX. Within the UST group, 2% switched to UST biosimilars. Treatment persistence rates up to 10 years were: 90% for IFX, 87% for ADA, 83% for GOL, 87% for VDZ, 87% for UST, 93% for IL-23, 86% for JAKi, and 89% for S1P. KM analysis revealed significant differences in persistence over the 10-year observation period (p = 0.003) (Figure 1). However, comparison of final persistence rates showed no significant differences between therapies (p = 0.519). Conclusion All patient groups demonstrated high persistence rates. The proportion of patients remaining on therapy ranged from 83% to 93%. KM analysis adjusting for varying follow-up times showed estimated 10-year persistence rates of 65–80% across all therapies. Only minor differences were observed between the groups. Conflict of interest: Dr. Plachta-Danielzik, Sandra: No conflict of interest Gilman, Elena: No conflict of interest Efken, Philipp: PE has received personal fees from: AbbVie, BMS, Galapagos, Janssen, and Amgen, outside the submitted work. Holtkamp Endemann, Frank: No conflict of interest von der Ohe, Manfred: No conflict of interest Schubert, Stefan: No conflict of interest Dinter, Johanna: No conflict of interest Jessen, Petra: No conflict of interest Darsow, Christina: No conflict of interest Kahl, Matthias: No conflict of interest Fajardo Salmon, Samantha: No conflict of interest Langness, Sina: No conflict of interest Tappe, Ulrich: UT has served as a consultant for Ferring, Abbvie, Janssen-Cilag, Falk-Foundation outside the submitted work. Schreiber, Stefan Wolfgang: Personal Fees: AbbVie, Alfasigma, Amgen, Arena, Biogen, Boehringer Ingelheim, Bristol Meyers Squibb, Celgene, Celltrion, Falk, Ferring, Fresenius Kabi, Galapagos, Gilead, IMAB, Janssen, Lilly, MSD, Mylan, Novartis, Pfizer, Protagonist, Provention Bio, Roche, Sandoz/Hexal, Shire, Takeda, Theravance Bokemeyer, Bernd: Grant: Abbvie, Ferring, UCB, Given Imaging, Janssen, Takeda, Pfizer, Galapagos, Lilly Personal Fees: Abbvie, Ferring, MSD, Merckle, Falk, HLR, UCB, Shield Therapeutics, Pfizer, Celltrion, Takeda, Janssen, Mundipharma, Arena, Galapagos, BMS, Lilly Other: Abbvie, MSD, Shire, Ferring, Hospira, Takeda, Shield Therapeutics, Pfizer, Biogen, Janssen, Hexal, Cellgene, Boehringer, Allergan, Galapagos, Arena Lilly
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S Plachta-Danielzik
E Gilman
Philipp Efken
Johannes Wesling Klinikum Minden
Journal of Crohn s and Colitis
University of Lübeck
University Hospital Schleswig-Holstein
IS practice
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Plachta-Danielzik et al. (Thu,) studied this question.
synapsesocial.com/papers/69730f59c8125b09b0d1f2b1 — DOI: https://doi.org/10.1093/ecco-jcc/jjaf231.931