Treatment patterns and determinants of persistence with advanced therapies in adults with newly diagnosed Crohn's disease: an interim analysis of an inception cohort registry study (iCREST-CD).
21 affiliations
- 1Department of Gastroenterology, Hyogo Medical University School of Medicine, Nishinomiya, Hyogo, 663-8501, Japan.
- 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Centre, Sakura, Chiba, 285-8741, Japan.
- 3Department of Gastroenterology and Hepatology, Institute of Science Tokyo, Bunkyo-ku, Tokyo, 113-8519, Japan.
- 4Inflammatory Bowel Disease Centre, Yokohama City University Medical Centre, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
- 5Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Tokyo, 181-0004, Japan.
- 6Department of Internal Medicine for Inflammatory Bowel Disease, Toyama University Hospital, Sugitani, Toyama, 930-0194, Japan.
- 7Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan.
- 8Department of Inflammatory Bowel Disease Centre, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, 818-8502, Japan.
- 9Division of Digestive Endoscopy, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan.
- 10Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan.
- 11Department of Surgery and Inflammatory Bowel Disease Centre, Yokkaichi Hazu Medical Centre, Yokkaichi, Mie, 510-0016, Japan.
- 12IBD Centre, Hokkaido Preventive Welfare Federation of Agricultural Cooperative, Sapporo-Kosei General Hospital, Sapporo, Hokkaido, 060-0033, Japan.
- 13Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, 812-8582, Japan.
- 14Centre for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Minato-ku, Tokyo, 108-8642, Japan.
- 15Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan.
- 16Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, 105-8471, Japan.
- 17Department of Gastroenterology, Matsuda Paediatric & Gastroenterology IBD Clinic, Ishikawa, 920-0981, Japan.
- 18Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, 020-0021, Japan.
- 19Division of Gastroenterology and Hepatology, Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8543, Japan.
- 20IBD Centre, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, 065-0033, Japan.
- 21Medical Affairs Division, Janssen Pharmaceutical K.K, Chiyoda-ku, Tokyo, 101-0065, Japan.
Abstract
Multiple advanced therapies are available for the treatment of Crohn's disease (CD). Treatment patterns in newly diagnosed patients and the factors associated with persistence remain unclear. We present interim results of the iCREST-CD registry describing treatment patterns and persistence with advanced therapies. Patients aged ≥16 years with newly diagnosed CD and who had no prior exposure to advanced therapies were enrolled. Persistence of advanced therapies was estimated using Kaplan-Meier analyses, and associated factors were identified using multivariable Cox proportional hazards models. Persistence was also compared between patients who initiated therapy early or later after diagnosis. Of 672 patients (68.2% male; mean age 29.4 ± 13.1 years), 498 (74.1%) initiated advanced therapy: infliximab (IFX; 121), adalimumab (ADA; 244), ustekinumab (UST; 107), or vedolizumab (VDZ; 26). Advanced therapy was initiated within 1 year of diagnosis in 404 (60.1%). The 36-month treatment persistence rates for IFX, ADA, UST, and VDZ were 77.5%, 75.7%, 79.8%, and 49.0%, respectively. After propensity score adjustment using inverse probability of treatment weighting, the early initiation was associated with greater persistence than delayed initiation, although the difference did not reach statistical significance (hazard ratio, 0.61; 95% confidence interval, 0.35-1.09; P = .067). A high prevalence of early advanced therapy use and a high level of persistence with first-line advanced therapy were identified in this national cohort. Early initiation was associated with greater treatment persistence than delayed initiation, suggesting the potential clinical relevance of earlier advanced therapy use in routine practice. These findings require confirmation in other prospective studies aiming to evaluate early intervention strategies. The study was registered with the University Hospital Medical Information Network Clinical Trials Registry (umin.ac.jp/ctr Identifier: UMIN000032237) prior to initiation.
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BibTeX
@article{shinzaki2026treatment,
title = {{Treatment patterns and determinants of persistence with advanced therapies in adults with newly diagnosed Crohn's disease: an interim analysis of an inception cohort registry study (iCREST-CD).}},
author = {Shinichiro Shinzaki and Katsuyoshi Matsuoka and Toshimitsu Fujii and Ryuichi Okamoto and Akihiro Yamada and Reiko Kunisaki and Minoru Matsuura and Kenji Watanabe and Hisashi Shiga and Noritaka Takatsu and Shigeki Bamba and Yohei Mikami and Takayuki Yamamoto and Takahiro Shimoyama and Satoshi Motoya and Takehiro Torisu and Taku Kobayashi and Naoki Ohmiya and Masayuki Saruta and Koichiro Matsuda and Takayuki Matsumoto and Hiroshi Nakase and Atsuo Maemoto and Shinichi Yoshigoe and Hiroaki Tsuchiya and Akiko Hori-Nishi and Tadakazu Hisamatsu and iCREST-CD Study Group},
journal = {Journal of Crohn's \& colitis},
year = {2026},
month = nov,
doi = {10.1093/ecco-jcc/jjag167},
url = {https://europepmc.org/article/MED/42998010},
note = {CC BY},
}
RIS
TY - JOUR
TI - Treatment patterns and determinants of persistence with advanced therapies in adults with newly diagnosed Crohn's disease: an interim analysis of an inception cohort registry study (iCREST-CD).
AU - Shinichiro Shinzaki
AU - Katsuyoshi Matsuoka
AU - Toshimitsu Fujii
AU - Ryuichi Okamoto
AU - Akihiro Yamada
AU - Reiko Kunisaki
AU - Minoru Matsuura
AU - Kenji Watanabe
AU - Hisashi Shiga
AU - Noritaka Takatsu
AU - Shigeki Bamba
AU - Yohei Mikami
AU - Takayuki Yamamoto
AU - Takahiro Shimoyama
AU - Satoshi Motoya
AU - Takehiro Torisu
AU - Taku Kobayashi
AU - Naoki Ohmiya
AU - Masayuki Saruta
AU - Koichiro Matsuda
AU - Takayuki Matsumoto
AU - Hiroshi Nakase
AU - Atsuo Maemoto
AU - Shinichi Yoshigoe
AU - Hiroaki Tsuchiya
AU - Akiko Hori-Nishi
AU - Tadakazu Hisamatsu
AU - iCREST-CD Study Group
PY - 2026
DA - 2026/11/01
JO - Journal of Crohn's & colitis
DO - 10.1093/ecco-jcc/jjag167
UR - https://europepmc.org/article/MED/42998010
AB - Multiple advanced therapies are available for the treatment of Crohn's disease (CD). Treatment patterns in newly diagnosed patients and the factors associated with persistence remain unclear. We present interim results of the iCREST-CD registry describing treatment patterns and persistence with advanced therapies. Patients aged ≥16 years with newly diagnosed CD and who had no prior exposure to advanced therapies were enrolled. Persistence of advanced therapies was estimated using Kaplan-Meier analyses, and associated factors were identified using multivariable Cox proportional hazards models. Persistence was also compared between patients who initiated therapy early or later after diagnosis. Of 672 patients (68.2% male; mean age 29.4 ± 13.1 years), 498 (74.1%) initiated advanced therapy: infliximab (IFX; 121), adalimumab (ADA; 244), ustekinumab (UST; 107), or vedolizumab (VDZ; 26). Advanced therapy was initiated within 1 year of diagnosis in 404 (60.1%). The 36-month treatment persistence rates for IFX, ADA, UST, and VDZ were 77.5%, 75.7%, 79.8%, and 49.0%, respectively. After propensity score adjustment using inverse probability of treatment weighting, the early initiation was associated with greater persistence than delayed initiation, although the difference did not reach statistical significance (hazard ratio, 0.61; 95% confidence interval, 0.35-1.09; P = .067). A high prevalence of early advanced therapy use and a high level of persistence with first-line advanced therapy were identified in this national cohort. Early initiation was associated with greater treatment persistence than delayed initiation, suggesting the potential clinical relevance of earlier advanced therapy use in routine practice. These findings require confirmation in other prospective studies aiming to evaluate early intervention strategies. The study was registered with the University Hospital Medical Information Network Clinical Trials Registry (umin.ac.jp/ctr Identifier: UMIN000032237) prior to initiation.
SN - 1873-9946
SN - 1876-4479
ER -