Biologic Switch Timing and Risk of Infection in Patients With Ulcerative Colitis/Crohn's Disease: A Retrospective...

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Limited real-world data exists on biologic therapy switch timing in ulcerative colitis (UC) and Crohn's disease (CD).
• Understanding infection risk associated with different biologic switching strategies is crucial for patient safety and effective disease management.

Purpose of the Study:

• To investigate real-world patterns of biologic therapy switches in UC/CD patients.
• To compare the risk of any infection and serious infection between overlapping (OS) and non-overlapping switches (NOS).

Main Methods:

• Retrospective observational study using de-identified claims data (2017-2022).
• Identified UC/CD patients initiating biologic therapy and categorized switch timing (OS: ≤5 half-lives, NOS: >5 half-lives).
• Used weighted Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) for infection risks.

Main Results:

• 1293 of 11,992 patients (10.8%) switched biologics; 64.2% were OS.
• Incidence rates of any infection were comparable between OS and NOS groups.
• No significant difference in adjusted hazard ratios for any infection (aHR=1.40, P=.17) or serious infection (aHR=0.95, P=.93) between OS and NOS.

Conclusions:

• Overlapping biologic switches are frequent in UC/CD clinical practice.
• Overlapping switches were not associated with an increased risk of serious infection compared to non-overlapping switches.
• Shortened washout periods may offer benefits for therapy management and clinical trial recruitment with minimal safety risks.