Biologic-naïve Patients with Crohn’s Disease are More Likely to Achieve Mucosal Healing than Biologic-experienced Patients: TARGET-IBD Real World Cohort.

Challenge

The higher rates of mucosal healing observed in biologic-naïve CD patients in clinical trials had not been validated in real-world practice, where patients are more heterogeneous and biologic sequencing varies. The degree to which prior biologic exposure affects mucosal healing rates in routine care was unknown.

Solution

The TARGET-IBD registry was used to compare mucosal healing rates between biologic-naïve and biologic-experienced CD patients initiating biologic therapy, with logistic regression identifying baseline factors associated with achieving mucosal healing on follow-up colonoscopy.

Impact

Confirming in real-world practice that biologic-naïve CD patients are significantly more likely to achieve mucosal healing than biologic-experienced patients validates the clinical trial finding and reinforces the case for early biologic use in CD before therapeutic failure, supporting prescriber education and payer arguments for timely advanced therapy initiation.