Exton, PA, Aug. 13, 2026 (GLOBE NEWSWIRE) -- The treatment paradigm for inflammatory bowel disease (IBD) may be shifting faster in physician preference than in clinical practice. Across Europe, gastroenterologists are expressing strong confidence in IL-23 inhibitors and favoring earlier use of advanced therapies, yet many patients with Crohn’s disease (CD) and ulcerative colitis (UC) remain on conventional treatments and TNF inhibitors continue to dominate first-line advanced therapy.
New findings from Spherix Global Insights’ RealTime Dynamix™: Crohn’s Disease (EU4+UK) Q2 2026 and RealTime Dynamix™: Ulcerative Colitis (EU4+UK) Q2 2026 highlight this disconnect across France, Germany, Italy, Spain, and the United Kingdom.
Physician attitudes increasingly support an earlier, more aggressive treatment approach to IBD management. In CD, three-quarters of gastroenterologists agree that the long-term risks of uncontrolled disease outweigh the risks associated with biologic or JAK inhibitor treatment, while nearly three-quarters favor a treat-to-target approach. In UC, more than half believe top-down treatment should be the standard of care for newly diagnosed patients with active diseases.
Clinical practice, however, tells a different story. Only about half of CD and UC patients are currently receiving an advanced biologic or small molecule, and gastroenterologists identify a notable portion of conventionally treated patients who could benefit from escalation to advanced therapy.
IL-23 inhibitors are particularly well positioned to benefit from a shift toward earlier advanced treatment. In CD, the class now narrowly leads TNF inhibitors as gastroenterologists’ “best overall” mechanism and is frequently viewed as the most efficacious option. A similar dynamic is emerging in UC, where IL-23 inhibitors are approximately at parity with TNF inhibitors in overall physician preference.
That preference has not yet displaced established prescribing patterns. TNF inhibitors remain firmly entrenched as the leading first-line advanced therapy in both CD and UC. Treatment inertia may also be contributing to the gap, with gastroenterologists often opting to optimize or extend current treatment before switching when response is suboptimal.
Access adds another layer of complexity and varies considerably by market. In UC, for example, Johnson & Johnson’s Tremfya (guselkumab) is available to just over half of surveyed gastroenterologists in France, compared with all surveyed gastroenterologists in Germany. Such differences may help explain why physician enthusiasm for newer mechanisms does not translate uniformly into prescribing across Europe.
Taken together, the findings suggest that IL-23 inhibitors have already made substantial progress on a key challenge typically faced by a newer therapeutic class: winning physician confidence. The next test is whether that preference translates into a meaningful shift in treatment patterns. European gastroenterologists report that roughly one-quarter of CD and UC patients currently receiving advanced therapy are achieving suboptimal results, pointing to a sizeable population that may be candidates for a treatment change. Against this backdrop, most gastroenterologists report being very likely to prescribe Tremfya to biologic-experienced patients with CD or UC, suggesting meaningful potential for the brand as treatment patterns evolve.
“What stands out is that physician preference appears to be moving ahead of prescribing behavior,” said Jim Hickey, Gastroenterology Franchise Head at Spherix Global Insights. “Gastroenterologists see a strong role for IL-23 inhibitors and are increasingly aligned around earlier, more effective disease control, but TNF inhibitors remain deeply established in the first-line advanced setting. The opportunity for IL-23s will ultimately depend on how quickly that gap between physician preference and real-world treatment begins to close.”
Crohn’s disease findings are drawn from Spherix Global Insights’ RealTime Dynamix™: Crohn’s Disease (EU4+UK) Q2 2026, a quantitative survey of 249 gastroenterologists across France, Germany, Italy, Spain, and the United Kingdom, fielded April 3-29, 2026. Ulcerative colitis findings are drawn from RealTime Dynamix™: Ulcerative Colitis (EU4+UK) Q2 2026, a quantitative survey of 253 gastroenterologists across the same five markets, fielded March 12-April 2, 2026.
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Spherix Global Insights is a leading independent provider of market intelligence and advisory services for specialty pharmaceutical and biotech markets. By combining physician, patient, and payer perspectives into a single integrated view, Spherix helps brand teams, market access stakeholders, and investors understand how a specialty market actually behaves, not how any one stakeholder describes it. The firm operates eight dedicated therapeutic franchises: Central Nervous System, Dermatology, Gastroenterology, Hematology, Nephrology, Oncology, Ophthalmology, and Rheumatology, alongside a fully dedicated Market Access team. Each franchise is led by hyper-focused analysts and researchers who track these specialty areas full-time, drawing on independently curated communities of vetted practicing specialists, KOLs, patients recruited through treating physicians and advocacy partners, and medical and pharmacy directors at commercial and government payers. Spherix delivers quarterly trending, launch tracking, chart audits, KOL synthesis, patient experience research, and payer and market access intelligence that support confident, strategic decision-making across the pharma lifecycle. Trusted by 19 of the top 20 pharmaceutical and biotech organizations, Spherix has been a go-to resource for more than a decade for leading brands, market access stakeholders, industry media outlets, financial analysts, professional organizations, and patient advocacy groups seeking an unbiased, holistic view of specialty markets.
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Jim Hickey, Gastroenterology Franchise Head Spherix Global Insights 484-879-4284 james.hickey@spherixglobalinsights.com
