Impact of early versus late use of biologic therapy on cumulative surgical rates in patients with IBD

OBJECTIVE: A treat-to-target therapy in IBD by the early initiation of biologic therapy may impact disease progression and avoidance of surgical-related events. This study aims to identify differences in surgical rates between patients who received early versus late biologic therapy. METHODOLOGY: This was a retrospective study from the UMMC IBD database from January 2009 until January 2022. All biologic experienced patients were included. The time of IBD diagnosis, the time of initiation of biologic therapy from disease onset, the duration of biologic therapy and the time to surgery were collected. Kaplan-Meier curve was used to determine the surgical survival rate with a significant p-value < 0.05. RESULTS: The study included 100 patients bionaïve patients with Crohn’s disease of which n=34, 34% had penetrating and/ or stricturing disease and (n=66, 66%) had non-stricturing non-penetrating disease Patients received Infliximab (n=57, 57%), Ustekunimab (n=16, 16%), Vedolizumab (n=17, 17%) and Adalimumab (n=10, 10%). However, 14% patients had a diagnosis of IBD post-surgery. 69.4% (n=52) patients received early biologic therapy (