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Patients diagnosed in 2006 and later were eligible. Analysis was restricted to treatment patterns within 1\u2009year of diagnosis. Multivariable logistic regressions examined differences by country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We recruited 202 CD (US: 49%, China: 51%) and 133 UC (US: 63%, China: 37%) participants. Median age at survey was 31\u2009years (range: 18\u201376) and at diagnosis was 28\u2009years (range: 12\u201370). Biologics were commonly used in the United States for CD (66%) and UC (28%) and less commonly in China for CD (19%) and UC (0%). On regression, US CD participants were more likely to receive biologics (odds ratio [OR] 23.82 [95% confidence interval [CI] 8.98\u201363.14]), aminosalicylates (OR 4.93 [2.00\u201312.15]), and steroids (OR 4.36 [1.87\u201310.16]). US UC participants were more likely to receive immunomodulators (OR 3.45 [1.09\u201310.90]) and steroids (OR 3.31 [1.55\u20137.06]). There existed minimal differences regarding undergoing surgery for CD (US: 16%, China: 16%) and UC (US: 5%, China: 2%). A proportion (US: 12%, China: 19%) underwent IBD\u2010related surgery prior to diagnosis (median: 5 years; range: 1\u201339).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>US, relative to Chinese, participants were more likely to report early biologic use. There were no differences between countries in undergoing early surgery. Evaluating global practice variation is integral to optimizing early pharmacological therapy and timing of surgery for patients with IBD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.12146","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T13:29:45Z","timestamp":1549286985000},"page":"234-241","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Initial medical and surgical management of inflammatory bowel disease in the biologic era: A comparison between the United States and China"],"prefix":"10.1002","volume":"3","author":[{"given":"Sanskriti","family":"Varma","sequence":"first","affiliation":[{"name":"The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Hu","sequence":"additional","affiliation":[{"name":"The Sixth Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong Providence China"},{"name":"Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital  Guangzhou Guangdong Providence China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambar","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Surgery Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiran","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology The Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Park","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhi","sequence":"additional","affiliation":[{"name":"The Sixth Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong Providence China"},{"name":"Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital  Guangzhou Guangdong Providence China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Hutfless","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology The Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32448-0"},{"key":"e_1_2_6_3_1","first-page":"22529","article-title":"The epidemiology and risk factors of inflammatory bowel disease","volume":"8","author":"Ye Y","year":"2015","journal-title":"Int. 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