Clinical Course and Predictors of Biologic Therapy, Hospitalisation and Surgery: A Five-Year Prospective Study in Newly Diagnosed Inflammatory Bowel Disease

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• Picked for Gastroenterology (paper of the day, 13 October 2026): Five‑year prospective outcomes in newly diagnosed IBD patients

Abstract

AIMS: This study aimed to describe the characteristics of newly diagnosed inflammatory bowel disease (IBD) patients and to analyse their clinical course within the first 5 years after diagnosis, including the need for surgery, hospitalisations and treatments. METHODS: This prospective and large multicentre incident cohort registry in Spain enrolled adults diagnosed with Crohn's disease (CD), ulcerative colitis (UC) or unclassified IBD (IBD-U) in 2017 and followed them for 5 years. RESULTS: A total of 3301 patients were enrolled: 1526 with CD, 1633 with UC and 142 with IBD-U. Their median age at diagnosis was 43 years (interquartile range 31-56) and approximately 50% were male. Within 5 years post-diagnosis, 30% received biologics or JAK inhibitors (JAKi), 34% were hospitalised at least once and 9% underwent surgery. The cumulative incidence of biologic/JAKi treatment, hospitalisations and surgeries was higher among CD patients. Use of biologics/JAKi correlated with a more aggressive CD phenotype, greater UC extent and younger age at diagnosis. Biologics/JAKi treatment was associated with lower hospitalisation risk in both CD (Hazard ratio [HR] = 0.4, 95% confidence interval [CI] = 0.2-0.6) and UC patients (HR = 0.5, 95% CI = 0.2-0.9). However, it was not associated with the risk of abdominal surgery in CD but was linked to an increased risk of surgery in UC (HR = 11.9, 95% CI = 4.6-30.4). CONCLUSIONS: This large multicentre cohort demonstrated a higher use of biologics/JAKi during the first 5 years after IBD diagnosis than previously reported. Treatment with biologics/JAKi was associated with reduced risk of hospitalisation. However, under current clinical practice patterns, this therapeutic approach did not translate into lower risk of abdominal surgery.

Abstract as published, via PubMed.