Persistence of biologic therapy in patients with inflammatory bowel diseases in the Chelyabinsk region

Aim. To assess the survival and reasons for discontinuation of genetically engineered biological therapy (GEBT) in patients with inflammatory bowel disease (IBD) in the Chelyabinsk region.

Materials and methods. In the period from 2014 to 2024, 249 patients with IBD in the Chelyabinsk region received GEBT or targeted immunosuppressants. Crohn's disease was diagnosed in 102 (41%) patients, ulcerative colitis (UC) – in 147 (59%). The primary endpoints of the study were survival and the effectiveness of GEBT, and the secondary endpoints were analysis of the reasons for discontinuation or change of therapy.

Results. Most often, drugs from the group of tumor necrosis factor á inhibitors were prescribed as the first line of therapy – 216 (86.7%). A total of 86 (34.5%) patients were transferred to the second-line therapy, and 19 (7.6%) patients with IBD required switching to the third line. The persistence of various GEBT drugs in the first line in patients with IBD during the analyzed period did not differ, but in patients with UC, the efficacy of infliximab was higher than adalimumab (p=0.019). In most cases ustekinumab and adalimumab were prescribed as the second-line therapy. No differences in persistence were found between the second-line GEBT drugs, but in pairwise comparison, the persistence of ustekinumab in patients with UC was statistically significantly higher compared to adalimumab (p=0.023). Allergic reactions and infections were recorded among the reasons for GEBT discontinuation in both the first and second lines in patients receiving tumor necrosis factor á inhibitors.

Conclusion. The persistence of the first line of GEBT in patients with IBD did not differ, in the second line ustekinumab demonstrated a longer survival compared to adalimumab in UC. The efficacy of infliximab in bionaive patients with UC was higher than adalimumab with comparable persistence of therapy.