P3304 - Newer Biologics Associated With Reduced Hospitalization Compared to TNF Inhibitors in Inflammatory Bowel Disease: A 5-Year Real-World Analysis

Omar Arman, MD, MPH¹, Sharifeh Almasaid, MD, MPH², Omar Daas, MD³, Ahmed Abdulelah, MD⁴, Abdulrahman Arman, MD³, Hebah Jaber, MD⁵, Mazen Zamzam, BS⁶, Jad Bou-Abdallah, MD¹
1University at Buffalo, Buffalo, NY; 2SUNY Upstate Medical University, Syracuse, NY; 3University of Jordan School of Medicine, Amman, 'Amman, Jordan; 4University of Cambridge, Cambridge, England, United Kingdom; 5Mutah University, Mutah, Al Karak, Jordan; 6Oakland University William Beaumont School of Medicine, Royal Oak, MI

Introduction: IBD affects millions of Americans and imposes substantial healthcare costs due to hospitalizations, a key marker of disease control. This study compares hospitalization rates between TNF inhibitors and newer biologics over 1, 3, and 5 years.

Methods: Using TriNetX, we conducted a retrospective cohort study of IBD patients ≥18 years who initiated TNF inhibitors or newer biologics (January 2015–December 2020). Propensity score matching balanced demographic and clinical characteristics (n = 20,354 per group). Hospitalization-free probabilities were assessed using Kaplan-Meier analysis, with hazard ratios (HR) and 95% confidence intervals (CI) calculated for comparative risk over time.

Results: Newer biologics consistently demonstrated lower hospitalization rates across all time points. At 1 year, the hospitalization rate was 8.1% for newer biologics vs. 11.1% for TNF inhibitors (p < 0.001; OR 1.414; 95% CI [1.328–1.508]). This trend persisted at 3 years (11.3% vs. 13.9%; p < 0.001; OR 1.263; 95% CI [1.209–1.349]) and 5 years (12.5% vs. 14.8%; p < 0.001; OR 1.219; 95% CI [1.175–1.305]). Kaplan-Meier analysis (Figure 2) demonstrated consistently higher hospitalization-free probabilities for newer biologics, with significant differences observed at 1 year (90.76% vs. 87.87%), 3 years (84.47% vs. 82.28%), and 5 years (79.39% vs. 78.07%; p < 0.001 for all time points). Figure 1 provides a detailed comparison of hospitalization rates, risk differences, and odds ratios across time points.

Discussion: Newer biologics significantly reduced hospitalization rates compared to TNF inhibitors, with differences observed as early as 1 year and sustained through 5 years. These findings highlight the potential for newer biologics to improve disease control and reduce healthcare costs in IBD management. Future research should investigate whether these reductions stem from improved disease control or fewer treatment-related adverse events.


Figure: Figure 1: Hospitalization rates and risk differences between TNF inhibitors (Old Biologics) and New Biologics at 1, 3, and 5 years, with corresponding odds ratios and 95% confidence intervals.



Figure: Figure 2: Kaplan-Meier survival probabilities comparing hospitalization-free outcomes for TNF
inhibitors (Old Biologics) and New Biologics over 1, 3, and 5 years.

Disclosures:
Omar Arman indicated no relevant financial relationships.
Sharifeh Almasaid indicated no relevant financial relationships.
Omar Daas indicated no relevant financial relationships.
Ahmed Abdulelah indicated no relevant financial relationships.
Abdulrahman Arman indicated no relevant financial relationships.
Hebah Jaber indicated no relevant financial relationships.
Mazen Zamzam indicated no relevant financial relationships.
Jad Bou-Abdallah indicated no relevant financial relationships.

Omar Arman, MD, MPH¹, Sharifeh Almasaid, MD, MPH², Omar Daas, MD³, Ahmed Abdulelah, MD⁴, Abdulrahman Arman, MD³, Hebah Jaber, MD⁵, Mazen Zamzam, BS⁶, Jad Bou-Abdallah, MD¹. P3304 - Newer Biologics Associated With Reduced Hospitalization Compared to TNF Inhibitors in Inflammatory Bowel Disease: A 5-Year Real-World Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.