Drug retention for advanced therapies for patients with ulcerative colitis and Crohn’s disease – a retrospective single center cohort study

Objective: To compare drug retention among commonly used advanced therapies (AT) for the treatment of ulcerative colitis (UC) and Crohn’s disease (CD). Design: Retrospective cohort study. Setting: Odense University Hospital, Denmark. Participants: All patients diagnosed with UC or CD who received biologic or targeted synthetic drug therapies between 1 November 2019 and 1 November 2024. Primary and secondary outcomes: The primary outcome was treatment persistence, defined as time to all-cause treatment discontinuation. Comparative persistence between AT was assessed using Cox proportional hazards regression. Secondary outcomes were median drug retention and one year treatment-survival-ra Results: A total of 751 patients (470 CD patients and 281 UC patients), representing 1201 treatment courses were included. In CD, Infliximab (IFX) demonstrated significantly longer drug retention compared with Adalimumab (ADA), Vedolizumab (VDZ) and Ustekinumab (UST). No significant differences were observed between the biologic-naïve and treatment-experienced subgroups. IFX achieved the longest median retention in the overall [51.0 months], naïve [57.5 months] and experienced [47.6 months] CD populations, as well as the highest one-year survival (84%). In UC, no significant differences in drug retention were observed across treatments. Golimumab (GOL) showed the longest overall median retention [36.5 months] and the longest retention among treatment-experienced patients [32.7 months], whereas IFX demonstrated the longest retention in biologic-naïve patients [34.3 months]. Conclusions: IFX was associated with significantly higher drug persistence in CD compared with ADA, VDZ and UST, whereas no clear differences were identified among treatments for UC.