COVID-19 State of Emergency and Biological Therapy Persistence for Ulcerative Colitis: An Interrupted Time Series
Mitsuhiro Mori1, Yoko M Nakao1,2, Munenori Honda1,3
1Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Pharmacoepidemiology and Drug Safety
|April 16, 2026
Summary
Ulcerative colitis patients maintained biological therapy persistence during Japan's COVID-19 state of emergency. The pandemic did not significantly impact treatment adherence for ulcerative colitis biologics.
Area of Science:
- Gastroenterology
- Immunology
- Public Health
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Biological therapies are crucial for UC management.
- The COVID-19 pandemic may have impacted healthcare access and patient adherence.
Purpose of the Study:
- To assess the impact of Japan's first COVID-19 state of emergency on biological therapy persistence in ulcerative colitis patients.
- To analyze changes in treatment non-persistence rates before and after the state of emergency.
Main Methods:
- Nationwide health insurance claims database analysis (2014-2022).
- Interrupted time series analysis to evaluate immediate and trend changes in non-persistence.
- Kaplan-Meier analysis to compare time to non-persistence between pre- and post-emergency initiators.
Main Results:
- 1197 UC patients receiving biological maintenance therapy were analyzed.
- No significant immediate level change (p=0.822) or trend change (p=0.167) in non-persistence was observed post-emergency.
- Kaplan-Meier analysis revealed no significant difference in time to non-persistence between patient groups.
Conclusions:
- Biological therapy persistence for ulcerative colitis remained stable during the COVID-19 state of emergency in Japan.
- The pandemic did not lead to a substantial change in treatment persistence for UC patients in this cohort.
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