{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:01:14Z","timestamp":1792144874923,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The therapeutic landscape for inflammatory bowel disease (IBD) has expanded rapidly beyond anti-TNF agents. We characterised the evolution of advanced therapy utilisation, persistence, and outcomes in a United Arab Emirates (UAE) cohort during 2015-2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective registry study from a tertiary IBD facility in the UAE included 508 patients (333 Crohn\u2019s disease [CD], 175 ulcerative colitis [UC]). Advanced therapies were grouped by mechanism of action. We compared prescribing patterns between 'Pre-2023' and '2023 and Beyond\u2019 eras. Treatment persistence was analysed using Kaplan-Meier methods and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 508 patients, 380 (74.8%) received advanced therapy. In CD, first-line anti-TNF use fell from 76% (pre-2023) to 42% (2023+), with anti-IL-23 agents emerging as a major first-line option (32%). Median time to first advanced therapy decreased dramatically: CD from 23.0 to 2.0\u2009months (p\u2009&amp;lt;\u20090.0001) and UC from 37.0 to 3.0\u2009months (p\u2009&amp;lt;\u20090.0001). Anti-IL-23 agents demonstrated significantly superior persistence in CD first-line therapy (p\u2009=\u20090.011 vs anti-TNF). In multivariable analysis, anti-IL-23 therapy was associated with significantly lower discontinuation risk (HR: 0.35, 95% CI: 0.19-0.64, p\u2009=\u20090.0008). Infliximab persistence appeared to improve over time, with significantly better 1-year persistence in 2024+ versus 2018-2019 (pairwise p\u2009=\u20090.020; overall trend p\u2009=\u20090.05). A shift in UC second-line prescribing was also observed (p\u2009=\u20090.048). Early surgery rates were low across both eras (CD: 6.5% vs 3.9%; UC: 2.5% vs 1.9%) with no significant difference in 35-month surgery-free survival, though this analysis was underpowered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IBD management in the UAE has undergone a rapid paradigm shift since 2023, characterised by earlier therapy initiation and diversification away from anti-TNF dominance, particularly in CD. Superior persistence of anti-IL-23 agents in our cohort is consistent with this evolution in clinical practice and supports its further evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/crocol\/otag057","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:04:46Z","timestamp":1781611486000},"source":"Crossref","is-referenced-by-count":1,"title":["Paradigm Shift in Inflammatory Bowel Disease Management\u2014Advanced Therapy Utilisation, Persistence, and Outcomes in a United Arab Emirates Cohort During 2015\u20132025"],"prefix":"10.1093","author":[{"given":"Hosameldin","family":"Abdelrahman Ahmed","sequence":"first","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Nasir","family":"Alzaabi","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaer Khaleel","family":"Swai","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaima Wasim","family":"Khan","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maitha","family":"Al Hosani","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noura","family":"Al Hosani","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam A","family":"Alahmad","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeen Mamon","family":"Omar","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enas Fouad","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishtiaq","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishore Kumar","family":"Chitra Kumar","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurette L","family":"Bukasa","sequence":"additional","affiliation":[{"name":"Abu Dhabi Health Data Services , Abu Dhabi,","place":["United Arab Emirates"]},{"name":"UCL Great Ormond Street Institute for Child Health, , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine","family":"Jess","sequence":"additional","affiliation":[{"name":"Aalborg University Center for Molecular Prediction of Inflammatory Bowel Disease, Department of Clinical Medicine, , Copenhagen,","place":["Denmark"]},{"name":"Aalborg University Hospital Department of Gastroenterology and Hepatology, , Aalborg,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Nabil","family":"Quraishi","sequence":"additional","affiliation":[{"name":"Sheikh Shakhbout Medical City Department of Gastroenterology, , Pure Health, Abu Dhabi,","place":["United Arab Emirates"]},{"name":"University of Birmingham Institute of Cancer and Genomic Sciences, , Birmingham,","place":["United Kingdom"]},{"name":"Khalifa University of Science and Technology College of Medicine and Health Sciences, , Abu Dhabi,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,16]]},"container-title":["Crohn's &amp; Colitis 360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otag057\/68537179\/otag057.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otag057\/68537179\/otag057.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:58:43Z","timestamp":1781647123000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article\/doi\/10.1093\/crocol\/otag057\/8709231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/crocol\/otag057","relation":{},"ISSN":["2631-827X"],"issn-type":[{"value":"2631-827X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"otag057"}}