Highlights of the 2026 European Crohn's and Colitis Conference: redefining the IBD care continuum.

Abstract

Introduction and purpose: Inflammatory bowel disease (IBD) care is moving from a symptom-driven step-up model of care toward earlier effective intervention, complication-specific management, and more personalized treatment selection. This review synthesizes selected ECCO 2026 studies and offers an expert appraisal of their clinical relevance, methodological strengths, and remaining uncertainties. Particular emphasis is placed on studies most likely to influence current practice and further research, including late-breaking trials, complication-directed therapy, pediatric evidence, and technology-assisted assessment.

Summary of findings: Study findings spanned both ulcerative colitis (UC) and Crohn's disease (CD). New therapeutic studies presented included the phase 3 study of vedolizumab in pediatric UC, phase 2 efficacy data for picankibart in UC, and regenerative fistula data of AVB-114 in perianal CD. Real-world data presented included comparative data on different Janus kinase inhibitors in UC. Updates on interleukin-23 included durable extension data in UC, as well as efficacy data in advanced therapy‑exposed patients (mirikizumab in UC and risankizumab in CD). Innovative technologies included transperineal ultrasound for early identification of steroid non-response in acute severe UC, and multimodal artificial intelligence for Mayo endoscopic scoring. Beyond drug therapy, the 10-year LIR! C follow-up provided further data on surgical intervention as an early strategy in selected uncomplicated ileal CD, while the Preventing IBD ONset in Individuals at Risk study investigated potential benefits of a whole-food diet in high-risk first-degree relatives.

Conclusion and next steps: ECCO 2026 emphasized durable, precision-oriented, multidisciplinary, and technology-enabled IBD care across the full continuum, from prevention to long-term modification. Apart from phase 3 and extension trials, other results remain preliminary and need broader comparative and practice-embedded studies before widespread adoption.