{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T22:09:55Z","timestamp":1778278195225,"version":"3.51.4"},"reference-count":44,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Biologic agents have emerged as the most important therapeutic weapon in the treatment of Crohn\u2019s disease (CD). The aim of this study is to describe the population of patients who received different molecules as first-line therapy and their persistence on first-line therapy. Materials and Methods: 622 patients from six gastroenterology departments from Bucharest, Iasi and Cluj treated between 2006 and 2024 were included in the study. A total of 87 (14%) were excluded because they received only mesalazine. A total of 535 were included in the final analysis. The main outcomes were clinical response and remission at 12 weeks of treatment and serious adverse events. Results: Three groups of patients were identified based on the first-line treatment: 45% of patients received adalimumab, 40% were treated with infliximab, and in 12.6% ustekinumab was given. Regarding the clinical and demographic characteristics, there are significant differences among the three patient groups in terms of age, disease extent, disease phenotype, proportion of individuals with perianal fistulas, clinical severity and the proportion of patients who underwent surgery. Median therapy duration was 48 months (6 \u00f7 330). The three biologics studied (adalimumab, infliximab and ustekinumab) had a similar rate of clinical remission of 80%, the non-response rate also being similar (6.5%), but persistence on therapy at 2 years was better for adalimumab (66%) and infliximab (60%) compared to ustekinumab (45%) (p = 0.06). Serious adverse events leading to therapy discontinuation were more frequent in those treated with infliximab (10%) compared to adalimumab (3%) and ustekinumab (6%) (p = NS). Conclusions: There were significant baseline differences between the treatment groups, so this study represents an unadjusted comparison between the results obtained with different biologics in first-line treatment for Crohn\u2019s disease. All three biological agents used in real life for Crohn\u2019s disease therapy show similar efficacy, with an early clinical remission rate of approximately 80% and a non-response rate of 6.5%.<\/jats:p>","DOI":"10.3390\/medicina62050901","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T14:05:46Z","timestamp":1778162746000},"page":"901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Comparative Study of Different Biological Drugs in First-Line Therapy in Crohn\u2019s Disease: A Multicenter Descriptive Analysis"],"prefix":"10.3390","volume":"62","author":[{"given":"Andrei","family":"Gila","sequence":"first","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Monica","family":"Preda","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mircea","family":"Diculescu","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Razvan Matei","family":"Bratu","sequence":"additional","affiliation":[{"name":"Anatomy Department, UMF \u201cCarol Davila\u201d, 0200201 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doina","family":"Istratescu","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor","family":"Stroie","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9144-5520","authenticated-orcid":false,"given":"Anca","family":"Trifan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5975-0779","authenticated-orcid":false,"given":"Alina","family":"Tantau","sequence":"additional","affiliation":[{"name":"Cluj CF University Hospital, UMF \u201cIuliu Hatieganu\u201d Cluj, 400347 Cluj, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-3829","authenticated-orcid":false,"given":"Sandica","family":"Bucurica","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5348-0341","authenticated-orcid":false,"given":"Cristian George","family":"Tieranu","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, Elias Emergency Hospital, 011461 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7736-8140","authenticated-orcid":false,"given":"Horia","family":"Minea","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Buzuleac","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3042-0754","authenticated-orcid":false,"given":"Lucian","family":"Negreanu","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Internal Medicine Department, Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Remus","family":"Popescu","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Internal Medicine Department, Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosmin Alexandru","family":"Ciora","sequence":"additional","affiliation":[{"name":"Gastroenterology & Hepatology Department, UMF \u201cCarol Davila\u201d, 020021 Bucharest, Romania"},{"name":"Gastroenterology & Hepatology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1016\/S0140-6736(16)31711-1","article-title":"Crohn\u2019s disease","volume":"389","author":"Torres","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1136\/gut.2005.082909","article-title":"The Montreal classification of inflammatory bowel disease: Controversies, consensus, and implications","volume":"55","author":"Satsangi","year":"2006","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0016-5085(76)80163-1","article-title":"Development of a Crohn\u2019s disease activity index. 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Dig."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/901\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T21:16:47Z","timestamp":1778275007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/5\/901"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":44,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["medicina62050901"],"URL":"https:\/\/doi.org\/10.3390\/medicina62050901","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]}}}