Changing Prescription Patterns in Pharmacologically Treated Patients with Newly Diagnosed Inflammatory Bowel Disease in German Gastroenterology Practices: A Real-World Study, 2015–2024

Background/Objectives: The therapeutic landscape of inflammatory bowel disease (IBD) has evolved, particularly with the expanding availability of biologic and targeted therapies. This study characterized real-world prescribing patterns among patients with newly diagnosed Crohn’s disease (CD) and ulcerative colitis (UC) in Germany. Methods: This retrospective study used the German IQVIA Disease Analyzer database. Patients aged 15–80 years diagnosed with CD or UC between 2015 and 2024, with ≥12 months of follow-up and at least one predefined treatment prescription within 12 months after diagnosis, were included. Prescription patterns were compared by IBD subtype, diagnosis period (2015–2019 vs. 2020–2024), age, and sex. Associations were assessed using multivariable logistic regression. Results: Overall, 10,009 patients were included (CD, n = 3810; UC, n = 6199). Mesalazine remained predominant in UC (89.7% in 2015–2019 vs. 87.9% in 2020–2024), whereas biologics were prescribed more frequently in CD and were more common in the later diagnosis period (CD: 32.2% vs. 54.0%; UC: 14.6% vs. 21.5%). UC was associated with higher odds of mesalazine prescription (OR 15.17) and lower odds of biologic prescription (OR 0.28) compared with CD. The later diagnosis period was associated with higher odds of biologic prescription (OR 2.00) and lower odds of mesalazine (OR 0.67) and thiopurine prescription (OR 0.59). Prescription patterns also differed by age, whereas sex-related differences were limited. Conclusions: Among pharmacologically treated patients with newly diagnosed IBD, prescription patterns differed substantially between diagnosis periods, with more frequent biologic and less frequent thiopurine and mesalazine prescriptions in the later period, particularly in CD. Patterns also differed by IBD subtype and age.