Crohn's & Colitis 360最新文献

{"title":"One-year dynamics of clinical activity during biologics therapy in patients of ulcerative colitis.","authors":"Yizhe Tie, Fengyuan Su, Jianwu Zhang, Minhui Zheng, Ningyi Li, Jieqi Zheng, Minhu Chen, Rirong Chen, Li Li, Shenghong Zhang","doi":"10.1093/crocol/otag074","DOIUrl":"10.1093/crocol/otag074","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal trajectories and the optimal timing for evaluating clinical activity remains unclear in ulcerative colitis (UC) patients receiving biologics.</p><p><strong>Methods: </strong>This study included 2705 UC patients from 5 trials and collected 28 807 records of partial Mayo scores (PMS) from baseline to week 52. Latent class growth mixed model was performed to construct 1-year PMS trajectories. Logistic regression assessed the association between PMS trajectories and 1-year therapeutic outcomes, and endoscopic remission was the primary outcome. Spearman correlation was utilized to identify the timepoints of PMS most correlated with the trajectories.</p><p><strong>Results: </strong>Five trajectories of clinical activity were identified, including rapid remission (<i>n</i> = 590, 21.8%), delayed remission (<i>n</i> = 316, 11.7%), mild improvement (<i>n</i> = 748, 27.7%), slow improvement (<i>n</i> = 915, 33.8%), and relapse-fluctuation (<i>n</i> = 136, 5.0%) groups. Endoscopic and histological remission rates exhibited a progressive decline across trajectory groups, with the highest probability in the rapid remission group and sequentially lower probabilities in the delayed remission, mild/slow improvement, and relapse-fluctuation groups (<i>P</i> < .001). Week-20 PMS demonstrated the strongest correlation with clinical activity trajectories (correlation coefficient = 0.7867, <i>P</i> < .001), with an area under curve of 0.9311 (95% CI: 0.9183, 0.9440). Furthermore, week-20 PMS could independently predicted 1-year endoscopic (aOR [95% CI] 0.59 [0.54, 0.65], <i>P</i> < .001) and histological (aOR [95% CI] 0.61 [0.53-0.70], <i>P</i> < .001) remission.</p><p><strong>Conclusions: </strong>UC patients receiving biologics would exhibit 5 distinct trajectories of clinical activity. Week 20 is a potential intermediate timepoint for clinical activity assessment to inform long-term outcomes.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag074"},"PeriodicalIF":1.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of adalimumab versus infliximab in children with Crohn's disease: real-world data from the prospective PIBD-SETQuality inception cohort study.","authors":"Stephanie A Vuijk, Renz C W Klomberg, Eva Katgert, Margreet M S Wessels, Erasmo Miele, Fiona L Cameron, Ivan D Milovanovich, Rafeeq Muhammed, David Devadason, James Hart, Dimitris Rizopoulos, Nicholas M Croft, Lissy de Ridder","doi":"10.1093/crocol/otag069","DOIUrl":"10.1093/crocol/otag069","url":null,"abstract":"<p><strong>Background: </strong>Infliximab and adalimumab are effective anti-tumor necrosis factor (anti-TNF) therapies for the treatment of pediatric Crohn's disease (CD). The aim of this study was to compare the effectiveness of infliximab and adalimumab in a real-world cohort of children with CD.</p><p><strong>Methods: </strong>Data from biological-naïve children with luminal CD (age 3-18 years) who commenced anti-TNF and completed at least 1 year of follow-up were collected from the prospective multicenter observational PIBD-SETQuality study. The primary outcome was steroid-free clinical remission (SFCR), defined as clinical remission (weighted pediatric Crohn's disease activity index [wPCDAI] <12.5) without systemic steroids or luminal surgery at 1 year. The relative risk (RR) of SFCR was calculated using standardization, correcting for the following baseline covariates: age, upfront anti-TNF, C-reactive protein, erythrocyte sedimentation rate, albumin, leukocytes, disease behavior, wPCDAI, perianal disease, and concomitant immunomodulator use. Secondary outcomes included the durability of anti-TNF treatment without luminal surgery.</p><p><strong>Results: </strong>Between January 1, 2017, and June 14, 2024, 178 patients with anti-TNF were included (infliximab: <i>n</i> = 121 [68%], adalimumab: <i>n</i> = 57 [32%]). At 12 months, 34/56 (61%) patients treated with adalimumab and 66/120 (55%) patients treated with infliximab had reached SFCR. The RR of SFCR at 1 year with adalimumab compared to infliximab was 1.25 (95% confidence interval [CI] 0.94-1.66], <i>P</i> = .13. Adalimumab was associated with a significant lower adjusted hazard ratio (aHR) of treatment discontinuation than infliximab in patients with a concomitant immunomodulator (aHR 0.17 [95% CI 0.04-0.75], <i>P</i> = .020), adjusted for upfront anti-TNF.</p><p><strong>Conclusions: </strong>In this prospective cohort of children with CD, adalimumab and infliximab showed comparable clinical effectiveness 1 year after the start of anti-TNF treatment.</p><p><strong>Clinical trial registration: </strong>The ClincalTrials.gov ID of this study is NCT03571373.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag069"},"PeriodicalIF":1.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of inflammatory bowel disease on mental health during pregnancy: a retrospective survey study.","authors":"Nikhila Butani, Serena Perera, Varun Srikanth, Vrati Mehra, Katie O'Connor, Karren Xiao, Yash Patel, Cynthia Maxwell, Nadia Griller, Talia Zenlea, Vithyaa Premjeyanth, Simone Vigod, Vivian Huang","doi":"10.1093/crocol/otag070","DOIUrl":"10.1093/crocol/otag070","url":null,"abstract":"<p><strong>Background: </strong>Individuals with inflammatory bowel disease (IBD) experience mental health disorders at rates 1.5-2 times higher than the general population. Many are affected during major life stages such as pregnancy, yet data on how IBD influences anxiety and depression in pregnancy remain limited.</p><p><strong>Methods: </strong>This retrospective survey study included patients from the \"Preconception and Pregnancy in IBD\" clinic who conceived before January 1, 2022. Standardized pre-visit surveys assessed anxiety (general anxiety disorder-7 [GAD-7]), depression (patient health questionnaire-9 [PHQ-9]), and IBD activity using pMayo6 for ulcerative colitis (UC) and mHBI for Crohn's disease (CD). Demographic variables included age, marital and employment status, smoking, alcohol and cannabis use, prior anxiety/depression diagnoses, IBD subtype, surgical history, and medication use. Linear regression models evaluated associations between disease activity and mental health outcomes, adjusting for medication type and stratifying by trimester and IBD subtype.</p><p><strong>Results: </strong>Ninety-four patients were included: 42 patients had UC (44.7%), and 52 patients had CD (55.3%). Median age was 32 (interquartile range [IQR] 31-35.8) for UC and 32.7 (IQR 30-35.2) for CD. Active UC in the second trimester was associated with significantly higher anxiety (<i>P</i> = 0.034) and depression (<i>P</i> = 0.022) scores compared to those with inactive UC. In the third trimester, this pattern persisted, with active UC again associated with elevated anxiety (<i>P</i> = 0.030) and depression (<i>P</i> = 0.027) scores. Active CD in the second trimester was significantly associated with higher anxiety (<i>P</i> = 0.024) and depression scores (<i>P</i> = 0.021) compared to those in remission.</p><p><strong>Conclusions: </strong>Active IBD during pregnancy is significantly associated with increased anxiety and depression. Multidisciplinary care, including mental health support, is imperative for pregnant people with IBD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag070"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial predictors of sustained clinical remission following the Crohn's disease exclusion diet in adults and microbiome shifts toward healthy pediatric controls.","authors":"Rotem Sigall-Boneh, Sarah Organ, Mohammed Ghiboub, Henit Yanai, Lee Abramas, Nicolette Wierdsma, Charlotte M Verburgt, Wouter J de Jonge, Joep P M Derikx, James D Lewis, Hong Gu, Joseph Bielawski, Nitsan Maharshak, Iris Dotan, Eytan Wine, Katherine Dunn, Johan Van Limbergen","doi":"10.1093/crocol/otag071","DOIUrl":"10.1093/crocol/otag071","url":null,"abstract":"<p><strong>Background: </strong>The Crohn's disease (CD) exclusion diet (CDED) is an emerging dietary therapy for inducing remission in CD. However, data on its effects on gut microbiome in adults remain limited. This study investigated microbial responses to CDED in adults with mild-to-moderate CD and compared them with pediatric patients and healthy pediatric controls.</p><p><strong>Methods: </strong>Microbiome data were analyzed from a randomized controlled trial (RCT) in adults (baseline, weeks 6, 12, 24) and a pediatric RCT (baseline, weeks 6, 12). Baseline microbial composition, diversity, and functional potential were compared between patients who achieved sustained clinical remission (SCR) at both weeks 12 and 24 and those who did-not. Functional profiling was performed using gene ortholog annotations, linear discriminant analysis, and metabolite inference.</p><p><strong>Results: </strong>Baseline microbial and functional profiles differed between patients with and without SCR. SCR was associated with lower alpha diversity, higher relative abundances of <i>Alistipes</i> and <i>Faecalibacterium</i>, and increased flagellin gene expression. SCR was associated with enrichment of genes for redox balance, fatty acid metabolism, and DNA repair, while non-SCR showed elevated NAD biosynthesis, bacterial adhesion, and pro-inflammatory pathways. <i>Haemophilus</i> and <i>Prevotella</i> were negatively linked to SCR. Compositional and functional microbiome analyses revealed a microbiome shift during CDED-induced remission toward a profile more similar to healthy pediatric controls.</p><p><strong>Conclusions: </strong>Before and during CDED, distinct baseline microbial and functional profiles were associated with SCR. These highlight the potential of the gut microbiome as a biomarker for identifying patients most likely to benefit from sustained effects of dietary therapy, supporting a more personalized approach to CD management.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag071"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world outcomes of subcutaneous infliximab in a Middle Eastern inflammatory bowel disease cohort: a prospective study of switch and de novo treatment strategies.","authors":"Maryam A Alahmad, Nadeen Mamon Omar, Mohammed Nabil Quraishi","doi":"10.1093/crocol/otag067","DOIUrl":"10.1093/crocol/otag067","url":null,"abstract":"<p><strong>Background: </strong>Subcutaneous (SC) infliximab offers pharmacokinetic and convenience advantages over intravenous (IV) therapy, but real-world data from the Middle East are lacking. This study evaluated SC infliximab outcomes in a prospective middle eastern inflammatory bowel disease (IBD) cohort.</p><p><strong>Methods: </strong>A prospective observational cohort study was conducted in the United Arab Emirates. Adult IBD patients were enrolled as switchers (transitioning from stable IV to SC infliximab 120 or 240 mg Q2W) or new starters (SC 120 mg Q2W following IV induction). Clinical outcomes and pharmacokinetics were assessed.</p><p><strong>Results: </strong>Fifty-eight patients were included (33 switchers [10 receiving 120 mg Q2W, 23 receiving 240 mg Q2W] and 25 new starters), with median follow-up of 10.1 months (interquartile range [IQR] 7.3-12.9). In the switcher cohort, 90.9% maintained clinical remission post-switch, with stable C-reactive protein (CRP), serum albumin, and fecal calprotectin, and significant increases in median trough concentrations: 9.5-20.0 mcg/mL in the 120 mg group (<i>P</i> = .044) and 8.0-42.0 mcg/mL in the 240 mg group (<i>P</i> = .001). Among new starters, 88% achieved clinical remission post-induction, with a median post-induction trough level of 16.0 mcg/mL; significant improvements in CRP, serum albumin, and fecal calprotectin were observed. Dose intensification was required in 28% of new starters. Drug persistence was high and comparable across all groups (log-rank <i>P</i> = .61), with 12-month rates of over 92% across all cohorts.</p><p><strong>Conclusions: </strong>SC infliximab is effective for both switching and de novo IBD management in a middle eastern population, delivering high clinical remission rates, robust drug exposure, and durable treatment persistence.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag067"},"PeriodicalIF":1.8,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agentic artificial intelligence in inflammatory bowel disease: toward autonomous and adaptive care.","authors":"Animesh Acharjee, Daniela Santos","doi":"10.1093/crocol/otag066","DOIUrl":"10.1093/crocol/otag066","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic, heterogeneous condition requiring ongoing monitoring and iterative therapeutic adjustment. Current management relies on multiple clinical, biochemical, imaging, and molecular data sources that are collected intermittently and rarely integrated into a unified representation of disease activity, leading to reactive clinical decision-making. Although artificial intelligence (AI) has demonstrated promise in IBD, most applications remain task-specific and operate on data collected at isolated time points, failing to capture the longitudinal nature of disease. Agentic AI offers a shift toward continuous and adaptive care by integrating diverse data streams into an evolving representation of disease state. This enables early detection of change and supports proactive intervention through a closed-loop system linking monitoring, interpretation, and action. Despite its potential, challenges related to data quality, interpretability, and clinical integration must be addressed for implementation.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag066"},"PeriodicalIF":1.8,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for early-onset venous thromboembolism in pediatric inflammatory bowel disease.","authors":"Caroline Chinchilla Putzeys, Nina Gautam, Andrew Ritchey, Amanda Kimberly, Umesh Sharma, Lucia Mirea, Laura Hamant, Hilary K Michel, Elizabeth Hilow, Ashish Patel, Sabina Ali, Jeremy Adler, Jonathan Moses, Brad Pasternak","doi":"10.1093/crocol/otag034","DOIUrl":"10.1093/crocol/otag034","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) can lead to a hypercoagulable state, particularly at initial diagnosis. Consequently, venous thromboembolism (VTE) represents a serious complication associated with IBD. For children, the risk of VTE near the time of IBD diagnosis has not yet been quantified, and guidance for VTE prophylaxis remains unclear.</p><p><strong>Methods: </strong>This multisite matched case-control study examined pediatric patients with a new diagnosis of IBD from 2019-2024. Cases were those who developed VTE ≤30 days prior or ≤90 days post IBD diagnosis. Controls were newly diagnosed IBD patients without VTE. Each case was matched to 2-6 controls based on IBD subtype and age at IBD diagnosis. Demographics, laboratory values, prothrombotic risk factors and treatments were compared between matched cases and controls using conditional logistic regression stratified, by case sets.</p><p><strong>Results: </strong>Study subjects included 15 cases and 52 controls, resulting in 70 matched pairs. Factors associated with early VTE included lower hemoglobin (<i>P</i> = .003), lower albumin (<i>P</i> = .002), corticosteroids use (<i>P</i> = .01), central line (<i>P</i> = .002), and any surgery ≤90 days post IBD diagnosis (<i>P</i> = .001). No association with VTE was detected for platelets, C-reactive protein, fecal calprotectin, family history of IBD or body mass index.</p><p><strong>Conclusions: </strong>Albumin, hemoglobin, steroid use, central line, and any surgery ≤90 days post IBD diagnosis were associated with early VTE. These risk factors may be used in a future prediction model to stratify newly diagnosed pediatric IBD patients by their risk for early VTE development.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag034"},"PeriodicalIF":1.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School life in children with inflammatory bowel diseases: from a national survey to a patient-driven awareness initiative.","authors":"Laura Gianolio, Valentina Silvera, Alice Bianchi, Francesca Penagini, Enrica Previtali, Salvo Leone, Gianvincenzo Zuccotti, Lorenzo Norsa","doi":"10.1093/crocol/otag062","DOIUrl":"10.1093/crocol/otag062","url":null,"abstract":"<p><strong>Background: </strong>School plays a crucial role in the daily life of pediatric patients with inflammatory bowel disease (IBD). Our study aimed to evaluate patients' perspectives on school environment and identify improvement areas.</p><p><strong>Methods: </strong>An anonymized patient-driven school survey was distributed via an online platform between February and November 2024 to all pediatric IBD patients and families registered with the Italian IBD patient association (AMICI).</p><p><strong>Results: </strong>Overall, 362 IBD patients responded, of whom 326/362 (90%) were in secondary school. Most respondents reported being aware of their disease (327/342, 96%). While the majority expressed a positive attitude towards school (269/342, 79%) and had disclosed their condition to at least 1 person at school (286/318, 90%), challenges were identified. Only 91/308 (30%) and 84/318 (26%) felt often understood by teachers and peers, respectively. Toilet access was problematic, with 225/318 (71%) expressing fear of using school bathrooms. Additionally, 80/313 (26%) experienced at least occasionally physical/verbal bullying. More than half (172/310, 55%) attended school despite feeling unwell to avoid criticism, with a minority having opportunities to catch up on missed lessons (95/261, 36%). To address these issues, patients' suggestions included training programs to educate teachers/peers and practical improvements in restroom access and absence management.</p><p><strong>Conclusions: </strong>This national patient-driven survey highlights substantial unmet needs in the school environment for children/young adults with IBD, underscoring the need for targeted interventions to improve inclusion and quality of life. Patient associations play a key role in identifying everyday challenges and fostering collaboration among clinicians, institutions, and policymakers to implement meaningful change.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag062"},"PeriodicalIF":1.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mirikizumab is equally effective in ustekinumab-exposed and ustekinumab-naïve patients with UC: a multicenter real-world cohort.","authors":"Mohmmed Tauseef Sharip, Dharmaraj Durai, Eva Vayreda, Nurulamin M Noor, Anushka Herath, Achini Withanachchi, Robin Dart, Sreedhar Subramanian, Miles Parkes, Mark A Samaan, Tim Raine, Peter M Irving","doi":"10.1093/crocol/otag065","DOIUrl":"10.1093/crocol/otag065","url":null,"abstract":"<p><strong>Background: </strong>Mirikizumab, a selective IL-23p19 monoclonal antibody, has demonstrated efficacy in moderate-to-severe ulcerative colitis (UC) although real-world data are limited. In addition, registrational trials excluded patients previously treated with ustekinumab, which targets the IL-12/23 p40 subunit. We aimed to evaluate the real-world effectiveness and safety of mirikizumab in a multicenter UK cohort of patients with UC, including those with prior ustekinumab exposure.</p><p><strong>Methods: </strong>A retrospective observational study was conducted across 3 tertiary UK centers. Adults with confirmed UC who received mirikizumab and had ≥12 weeks of follow-up were included. Data on demographics, disease activity (SCCAI, UCEIS), biomarkers (CRP, fecal calprotectin), and treatment persistence were analyzed at 3 and 6 months. Outcomes were compared between ustekinumab-exposed and ustekinumab-naïve patients.</p><p><strong>Results: </strong>Among 100 patients (36 ustekinumab-exposed), treatment persistence at 3 months was 72% with no significant difference between groups. SCCAI scores decreased from 5.8 to 3.3 at 3 months (<i>P</i> < .00001), and fecal calprotectin decreased from 1094 µg/g to 586 µg/g (p = 0.006). UCEIS scores (<i>n</i> = 36) improved significantly post-induction (mean 4.4 to 2.7, <i>P</i> < .000001). Multivariable logistic regression did not reveal any factors associated with treatment persistence, including prior ustekinumab exposure. Adverse events were infrequent and mild.</p><p><strong>Conclusion: </strong>Mirikizumab is effective and well tolerated in a real-world UC population, including patients with prior ustekinumab exposure. These findings support the use of IL-23p19 inhibition regardless of previous IL-12/23 blockade.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag065"},"PeriodicalIF":1.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness of guselkumab for induction of remission in Crohn's disease: a prospective multicenter cohort study with propensity score-matched comparison to risankizumab.","authors":"Maitha Al Hosani, Noorah Al Hosani, Mohamed Nasir Alzaabi, Maryam A Alahmad, Nadeen Mamon Omar, Camille Conde Oribiana, Enas Fouad Ahmed, Ishtiaq Ahmed, Kishore Kumar Chitra Kumar, Sofia Hanif, Khalid Izzeldin Elfatih Barakat, Khalid Osman Elamin Elsayed, Mohammed Nabil Quraishi","doi":"10.1093/crocol/otag061","DOIUrl":"10.1093/crocol/otag061","url":null,"abstract":"<p><strong>Background: </strong>No head-to-head trials compare selective interleukin-23 inhibitors in Crohn's disease (CD), leaving clinicians without direct evidence to guide treatment selection. We aimed to evaluate the real-world induction effectiveness of guselkumab in CD and perform propensity score-matched (PSM) comparisons against risankizumab.</p><p><strong>Methods: </strong>This prospective multicenter study included adults with moderate-to-severe CD initiating guselkumab in the United Arab Emirates. The primary outcome was clinical remission at Week 12 (Harvey-Bradshaw Index <5). Full propensity score matching between guselkumab and risankizumab cohorts controlled for 12 covariates, including disease phenotype, baseline endoscopic and biochemical activity, surgical history, and current smoking status.</p><p><strong>Results: </strong>Fifty-one guselkumab and 60 risankizumab patients were included. In the guselkumab cohort, 71% were advanced therapy-exposed with a median of 2 prior advanced therapies. At Week 12, clinical remission was achieved in 51% (26/51) and clinical response in 86% (44/51). Median C-reactive protein (CRP) decreased from 8.5 to 3.0 mg/L (<i>P</i> = .002) and fecal calprotectin from 216 to 80 μg/g (<i>P</i> < .001). Effectiveness was consistent regardless of prior treatment history. On univariable analysis, higher baseline HBI (OR 0.77, <i>P</i> = .011), SES-CD (OR 0.87, <i>P</i> = .049), and CRP (OR 0.94, <i>P</i> = .019) were associated with lower remission likelihood. Maintenance dosing was 100 mg Q8W in 73% and 200 mg Q4W in 27%. PSM analysis demonstrated comparable clinical remission (51% vs 50%, <i>P</i> > 0.9) and clinical response (86% vs 87%, <i>P</i> = .87) between guselkumab and risankizumab, with no significant between-group biomarker differences.</p><p><strong>Conclusions: </strong>Guselkumab demonstrated robust real-world induction effectiveness comparable to risankizumab across clinical and biochemical outcomes. These findings warrant confirmation in larger, longer-term comparative studies with endoscopic endpoints.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag061"},"PeriodicalIF":1.8,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}