Intestinal Research

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Original Article

Real-world use and perceptions of advanced combined therapies in treating inflammatory bowel disease: Hsin-Yun Wu, Zhi-Che Chen, Meng-Tzu Weng, Agnes Hiu Yan Ho, Joyce Wing Yan Mak, Rupert W Leong, Siew-Chien Ng, Uma Mahadevan, Fernando Magro, Deng-Chyang Wu, Shu-Chen Wei; Received December 18, 2025 Accepted March 17, 2026 Published online May 19, 2026; DOI: https://doi.org/10.5217/ir.2025.00325 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Combining therapies targeting distinct pathways shows promise in breaking the therapeutic ceiling for inflammatory bowel disease. The study explored real-world experiences and gaps between current evidence and clinical practice regarding advanced combined therapies.
Methods
A cross-sectional online survey was conducted via QR code during meetings or email invitation. The survey covered participant demographics, experiences with advanced combined therapies for ulcerative colitis, Crohn’s disease, and knowledge of these therapies.
Results
Between March and October of 2024, 234 participants from 20 countries replied and 51.7% had adopted advanced combined therapies (86.0% had treated ulcerative colitis, 66.9% Crohn’s disease, and 52.9% both). Among the 48.3% who had no experience, 76.1% would try if indicated. Refractory diseases were the most common indications. For combined therapies duration, 52.8% were time-oriented, favoring limited use within 6 months. Physicians reported no adverse events in 59.5% of cases. Of the events, infections (69.8%) were most common. Add-on strategy was the most commonly adopted, particularly the Janus kinase inhibitor added on anti-integrin for ulcerative colitis and anti-tumor necrosis factor alpha added on anti-interleukin 12/23 for Crohn’s disease. Concomitant strategy followed, while sequential strategy was the least used. More non-Asian experts were experienced (82.4%) compared to Asian participants (46.5%). Both inexperienced and non-Asian physicians preferred add-on strategy, but prioritized goal-oriented use, targeting clinical and endoscopic remission.
Conclusions
In real-world practice, advanced combined therapies were primarily used for refractory inflammatory bowel disease with limited duration. Add-on use was the most adopted. Differences in treatment approaches reflect varying levels of physician experience and geographical locations.

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Brief Communication

IBD

The impact of clinical experience on decision-making regarding the treatment and management of mild-to-moderate ulcerative colitis: Jae Hee Cheon, Kristine Paridaens, Sameer Al Awadhi, Jakob Begun, John R Fullarton, Edouard Louis, Fernando Magro, Juan Ricardo Marquez, Alexander R Moschen, Neeraj Narula, Grazyna Rydzewska, Axel U Dignass, Simon PL Travis; Intest Res 2023;21(1):161-167. Published online April 18, 2022; DOI: https://doi.org/10.5217/ir.2022.00006

PDF Supplementary Material PubReader ePub

Citations

Citations to this article as recorded by

Ten-Year Trend in 5-Aminosalicylic Acid Prescription Patterns and Treatment Outcomes in Patients with Ulcerative Colitis: An Analysis of Korean Health Insurance Data
Soo Jung Park, Sang Won Park, Jae Hee Cheon
Digestive Diseases and Sciences.2026; 71(6): 2218. CrossRef
Evolution of inflammatory bowel disease in Korea: a 60-year perspective on clinical and research development
Suk-Kyun Yang
Intestinal Research.2025; 23(3): 233. CrossRef
New genetic biomarkers predicting 5-aminosalicylate-induced adverse events in patients with inflammatory bowel diseases
Jihye Park, I. Seul Park, Ji Hyung Kim, Jung Hyun Ji, Soo Jung Park, Jae Jun Park, Tae Il Kim, Seung Won Kim, Jae Hee Cheon
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef

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