Treatment Journey among patients with moderate ulcerative colitis in the United States: TARGET-IBD.

Challenge

The real-world treatment journey of patients with moderate UC—including cycling between conventional therapies, rates of corticosteroid use, and predictors of advanced therapy initiation—had not been characterized in a large prospective US cohort, limiting understanding of the care gap in this population.

Solution

The TARGET-IBD registry was used to map the treatment journey of moderate UC patients from conventional therapy initiation through advanced therapy, generating Sankey diagrams of treatment sequences and identifying predictors of advanced therapy initiation using Fine-Gray hazard regression.

Impact

Documenting that moderate UC patients cycle extensively between 5-ASA, immunomodulators, and corticosteroids—and that racial/ethnic minority status significantly reduces the likelihood of advanced therapy initiation—provides actionable evidence for health equity programs and prescriber education in UC.