{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:31:07Z","timestamp":1777883467726,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AbbVie Korea"},{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["21153MFDS601"],"award-info":[{"award-number":["21153MFDS601"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Chronic Disease"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Biologics and small-molecule therapies are commonly used for long-term maintenance in patients with inflammatory bowel disease (IBD), including Crohn\u2019s disease (CD) and ulcerative colitis (UC). Dose escalation is often required to maintain treatment response, but real-world data on its frequency and contributing factors are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate patterns of dose escalation during maintenance treatment and identify patient- and treatment-related factors associated with dose escalation in IBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective, population-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using data from the Korean Health Insurance Review and Assessment Service (HIRA), we identified adults with CD or UC who initiated maintenance treatment with biologics or small-molecule agents between 2018 and 2022. Dose escalation was defined as two consecutive doses \u2a7e50% higher than the expected daily dose within 1\u2009year of treatment initiation. Multivariable logistic regression was used to assess associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 2,186 patients with CD and 1,806 with UC, dose escalation occurred in 20.9% and 14.1%, respectively. In CD, ustekinumab had the highest escalation rate (69.1%), compared with infliximab (16.4%), adalimumab (21.2%), and vedolizumab (23.2%). For UC, adalimumab was most frequently escalated (21.8%), followed by tofacitinib (19.5%), ustekinumab (17.9%), and infliximab (10.0%). Steroid use, later lines of therapy (third- and fourth-line) were significantly associated with increased odds of dose escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dose escalation is a common occurrence in IBD maintenance therapy, with substantial variation across treatment agents and patient profiles. These findings emphasize the importance of individualized treatment strategies to improve long-term disease control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27558428261419710","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T02:41:53Z","timestamp":1774320113000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns and factors associated with dose escalation during maintenance treatment for inflammatory bowel disease: a population-based cohort study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-9205","authenticated-orcid":false,"given":"Dahye","family":"Ryu","sequence":"first","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea"},{"name":"College of Pharmacy, Kyung Hee University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2760-2429","authenticated-orcid":false,"given":"Hyun Jin","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea"},{"name":"College of Pharmacy, Kyung Hee University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5875-1125","authenticated-orcid":false,"given":"Junghyun","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea"},{"name":"College of Pharmacy, Kyung Hee University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6713-1409","authenticated-orcid":false,"given":"Seoyeon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea"},{"name":"College of Pharmacy, Kyung Hee University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4321-6106","authenticated-orcid":false,"given":"Young Mi","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea"},{"name":"College of Pharmacy, Kyung Hee University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3445-6607","authenticated-orcid":false,"given":"Hae Sun","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Republic of Korea"},{"name":"College of Pharmacy, Kyung Hee University, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30358-9"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.09.076"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000891"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.09.046"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i41.6172"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1740034"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjae091"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjab178"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/apt.18006"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-326390"},{"key":"e_1_3_3_12_2","article-title":"Treatment of inflammatory bowel disease: a comprehensive review","volume":"8","author":"Cai Z","year":"2021","unstructured":"Cai Z, Wang S, Li J. 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