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Biologic Overlap During Medication Switches Is Safe in IBD
If you take biologic therapy for Crohn’s disease or ulcerative colitis, this study suggests brief overlaps when switching drugs may not increase infection risk, which could mean fewer gaps in treatment and less risk of symptom worsening during switches.
Adult patients on biologic therapy, clinicians who manage biologic switching, patients considering or undergoing a biologic switch, and researchers studying biologic safety and switching strategies.
What To Know
SHORT SUMMARY: A US retrospective claims study reported that overlapping biologic therapy when switching biologics for IBD (UC or Crohn’s) was common and not linked to higher infection risk compared with nonoverlapping switches.
The study included adults who newly started biologics (listed in the article) between 2017–2022 and classified overlaps based on a five–half-life window. This article reports on observational claims-data research suggesting shorter washout periods or brief overlaps during switching may not increase overall or serious infection risk.
The authors note overlapping switches were frequent (about two-thirds of switches) and that the most common overlapping switch involved vedolizumab. The study was funded by Sanofi and has limitations inherent to claims-data analyses.
PRACTICAL POINTS: The study does not establish causality or change clinical guidelines; decisions about switching timing should remain individualized and discussed with your treating clinician.
The research may prompt reconsideration of long mandated washout windows, but further independent studies and guideline updates would be needed before routine practice changes.
This was a US insurance claims–based retrospective study with possible coding misclassification and limited generalizability outside insured US populations. The study was funded by Sanofi and included authors with industry ties.
It does not replace clinical judgment or current regulatory guidance; further independent research and guideline review would be needed to change standard practice.
