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Biologic dose escalation in inflammatory bowel disease in the United States - PubMed

3 hours ago
  • #inflammatory bowel disease
  • #biologic therapy
  • #health care costs
  • Biologic dose escalation is a common therapy adjustment for inflammatory bowel disease (IBD) patients experiencing loss of response.
  • The study analyzed 6,056 Crohn's disease (CD) and 4,533 ulcerative colitis (UC) patients initiating biologics (adalimumab, infliximab, ustekinumab, vedolizumab, or tofacitinib for UC).
  • Dose escalation occurred in 30.4% of CD and 30.1% of UC patients, with infliximab showing the highest escalation rates (48.8% CD, 44.8% UC).
  • Patients with dose escalation had lower discontinuation rates but higher post-discontinuation switching compared to non-escalators.
  • IBD-related health care costs were substantial, driven by biologic costs, with ustekinumab being the most expensive ($14,031 CD, $14,246 UC PPPM).
  • Dose escalation significantly increased IBD-related health care costs, highlighting challenges in long-term biologic therapy and the need for optimized management strategies.