Crohn's & Colitis 360最新文献

{"title":"Dual-targeted therapy with risankizumab and upadacitinib in medically complex Crohn's disease.","authors":"Evan N Fear, Benjamin D McDonald, Megan S Kennedy, Alex J Mathew, Ross H McMillan, Zachary D Fine, Alexandra R McDermott, David Choi, Amelia Kellar, David T Rubin","doi":"10.1093/crocol/otag049","DOIUrl":"10.1093/crocol/otag049","url":null,"abstract":"<p><strong>Background: </strong>There are significant unmet needs for the treatment of Crohn's disease (CD). We have previously described a novel dual-targeted therapy (DTT) of the interleukin-12/23 (IL-12/23) inhibitor ustekinumab and selective Janus kinase 1 inhibitor upadacitinib (UPA). Here, we evaluate the safety and effectiveness of the IL-23 inhibitor risankizumab (RISA) combined with UPA in patients with CD.</p><p><strong>Methods: </strong>We retrospectively analyzed data from our prospectively collected real-world database of patients with CD at the [Institution Name] treated with the combination of RISA and UPA from November 05, 2021 to September 18, 2024. Clinical response and remission, extraintestinal manifestation outcomes, and adverse events were evaluated in all patients, including ileostomy patients.</p><p><strong>Results: </strong>Nineteen patients with CD were treated with RISA and UPA (median age 38 years [interquartile range, IQR 33.5-43.5], 13/19 [68%] female, median disease duration at DTT initiation 14.1 years [IQR 10.9-22.8], 14/19 [73.7%] had prior inflammatory bowel disease [IBD] surgeries, 5/19 [26.3%] had ileostomies). At DTT initiation, most patients had been treated previously with more than 4 prior advanced therapies (median 5, IQR 4-6). Among patients with clinically active disease at baseline, 5/7 (71.4%) achieved clinical remission and 2/7 (28.6%) achieved clinical response without remission. All 4 ileostomy patients with active disease responded, and 2 achieved clinical remission. Eight patients had active EIMs at baseline; 7/8 (87.5%) improved, with 4 achieving resolution. Three patients discontinued DTT due to adverse events (acne [1], fatigue [1], and upper respiratory infection [1]).</p><p><strong>Conclusion: </strong>DTT with RISA and UPA is effective and safe in medically resistant CD.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag049"},"PeriodicalIF":1.8,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293788","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":"Relationship between pregnancy, delivery, and ileal pouch-anal anastomosis for inflammatory bowel disease: a retrospective chart review.","authors":"Sarah C House, Varun Srikanth, Parul Tandon, Katie O'Connor, Brenda O'Connor, Gajuna Mathiyalagan, Cynthia Maxwell, Erin Kennedy, John W Snelgrove, Anthony de Buck van Overstraeten, Mantaj Brar, Vivian Huang","doi":"10.1093/crocol/otag048","DOIUrl":"10.1093/crocol/otag048","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women with inflammatory bowel disease (IBD) and an ileal pouch-anal anastomosis (IPAA) often receive conflicting medical advice regarding mode of delivery, and healthcare providers may have diverging opinions. Cesarean delivery is commonly performed out of concern of injuring the anal sphincter during vaginal delivery, causing poorer long-term pouch function. This study aims to describe rates of vaginal and cesarean delivery, complication rates and assess the impact of pregnancy and delivery on pouch function for patients with IBD and an IPAA.</p><p><strong>Methods: </strong>This retrospective single center chart review study included patients with IBD, an IPAA, and a completed pregnancy between January 1, 2002 and February 1, 2021. Patient demographics, IBD diagnosis, IPAA procedure details, mode of delivery and complications, and pouch function surrounding pregnancy were compared using descriptive statistics.</p><p><strong>Results: </strong>Sixty-two patients completed 85 pregnancies. Eighty-one percent of pregnancies had a cesarean delivery (69/85); of these, 51 (73.9%) were planned elective cesareans while 18 (26.1%) were urgent. Among the planned elective cesareans, 51.6% were indicated to prevent injury to the anal sphincter and preserve pelvic pouch function. Immediate risks of cesarean and vaginal delivery were similar to the general population. Rates of delivery intervention with episiotomy were high (50% of vaginal deliveries). All vaginal deliveries took place in the later 10 years of the study period. Pouch function postpartum was infrequently documented.</p><p><strong>Conclusions: </strong>Pregnant patients with IBD and an IPAA frequently had a cesarean delivery, often to avoid anal sphincter injury from vaginal delivery and preserve pelvic pouch function. Delivery practices shifted in the past 10 years to include vaginal delivery, likely reflecting an increased perceived safety of this delivery mode.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 3","pages":"otag048"},"PeriodicalIF":1.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419427","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":"Voluntary childlessness and family planning in men with inflammatory bowel disease: a scoping review.","authors":"Sara Ma, Victoria Jones, Simona Fourie, Wladyslawa Czuber-Dochan, Paul Galdas","doi":"10.1093/crocol/otag046","DOIUrl":"10.1093/crocol/otag046","url":null,"abstract":"<p><strong>Background: </strong>Chronic disease can influence family planning decisions, yet this remains under-researched in men. Understanding voluntary childlessness and family planning in men with inflammatory bowel disease (IBD) is essential to inform person-centered, disease-specific, and holistic support. A systematic synthesis of the published literature on childlessness and family planning in men with IBD was required to identify gaps in knowledge and inform future research, policy, and clinical care.</p><p><strong>Methods: </strong>Scoping review in accordance with the Joanna Briggs Institute guidance and reported in line with the PRISMA-ScR checklist. MEDLINE, EMBASE, CINAHL, and PsychInfo were searched. Two reviewers independently screened and selected relevant studies. Data were extracted, charted and then synthesized using the Patterns, Advances, Gaps, Evidence for practice, and Research recommendations (PAGER) Framework.</p><p><strong>Results: </strong>A total of 15 papers, reporting data from 1336 men with IBD were included in the review. The findings indicate that IBD may influence men's reproductive decision-making, with medication safety emerging as a key concern. Men also appear to have poorer reproductive knowledge compared with women with IBD. Few studies have involved partners, and the impact of IBD on partners remains largely undocumented.</p><p><strong>Conclusions: </strong>This review highlights the significant lack of research, clinical guidance, and patient education regarding men's family planning decisions in the context of IBD. Men and their partners require tailored, disease-specific information to support informed reproductive choices. Clinicians should recognize the potential impact of IBD on family planning and provide clear guidance on fertility and treatment-related risks, ensuring that management decisions are aligned with patients' reproductive intentions.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag046"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293861","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":"Long-term treatment outcomes of upadacitinib for Crohn's disease: a single-center retrospective study.","authors":"Takahiro Ito, Kohei Matsunaga, Yuya Ohno, Muchir Shi, Atsuo Maemoto","doi":"10.1093/crocol/otag047","DOIUrl":"10.1093/crocol/otag047","url":null,"abstract":"<p><strong>Background: </strong>Upadacitinib is the sole Janus kinase inhibitor approved for Crohn's disease in Japan, with its short-term efficacy already known. However, its long-term real-world outcomes remain unclear. This study aimed to evaluate its long-term continuation rates in patients with Crohn's disease and to identify predictive factors for sustained treatment.</p><p><strong>Methods: </strong>This single-center retrospective study included 41 patients with Crohn's disease treated with upadacitinib between July 2023 and April 2025. Continuation rates at 1 and 2 years defined the primary outcomes. Furthermore, predictive factors for treatment discontinuation, predictive scoring system development, upadacitinib's effects on perianal draining fistulas, endoscopic outcomes, and adverse events were the secondary outcomes.</p><p><strong>Results: </strong>The cumulative continuation rates were 67% and 63% at 1 and 2 years, respectively. In univariate analysis, factors such as age ≥ 40 years, penetrating disease behavior, prior intestinal resection, small-bowel stoma, prior exposure to ≥3 biologics, low baseline inflammation (C-reactive protein < 0.34 mg/dL and Simple Endoscopic Score for Crohn's Disease < 8), week 4 hemoglobin < 11.4 g/dL, week 4 albumin < 4.1 g/dL, and 5-aminosalicylic acid nonuse were associated with upadacitinib discontinuation. A predictive scoring system (0-8 points) demonstrated that patients with scores <3 had significantly better continuation rates than those with scores ≥3 (median: 703 vs. 341 days). Within 24 weeks of upadacitinib use, 2 of 5 patients developed perianal fistula closure.</p><p><strong>Conclusions: </strong>In Crohn's disease, upadacitinib continuation rates can be predicted using baseline patient characteristics and early biomarkers at week 4.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag047"},"PeriodicalIF":1.8,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249607","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":"A multicentered retrospective cohort study comparing JAK inhibitor therapies in moderate-to-severe ulcerative colitis.","authors":"Aditi Kumar, Joshua Baxter, Peter Rimmer, Ben Noble, Joshua Bower, Mujeeb Ullah Makki, Ayiesha Hatta, Anmol Chikhlia, Jonathan Cheesbrough, Ben Disney, Josh Muir, Mariya Karova, Jeffrey Butterworth, Nidhi Sagar, Ismaeel Al-Talib, Jasbir Nahal, Nasima Ali, Vandana Sagar, Fumi Varyani, Sam Smith, Stephanie Bourne, Yu-Kai Hsu, Almoiez Eltahir, Shanika de Silva, Philip Harvey","doi":"10.1093/crocol/otag045","DOIUrl":"10.1093/crocol/otag045","url":null,"abstract":"<p><strong>Background: </strong>Tofacitinib, filgotinib, and upadacitinib are Janus kinase inhibitors (JAKi) that have demonstrated efficacy in ulcerative colitis (UC) against placebo. This study aims to compare the clinical efficacy between these drugs.</p><p><strong>Methods: </strong>This is a multicentered, retrospective cohort study. Patients with UC starting a JAKi were recruited between 2018 and 2024 when starting their first JAKi. Clinical remission and response, based on clinical scores, calprotectin, and endoscopic measurement, were assessed at 3 and 6 months. Both independent and combined variable outcomes were analyzed.</p><p><strong>Results: </strong>Two hundred and seventy patients were included in the analysis, of which 70 (26%) were on upadacitinib, 51 (19%) on filgotinib, and 149 (55%) on tofacitinib. Clinical, biochemical, and endoscopic remission at 6 months was 91%, 71%, and 80% for upadacitinib; 78%, 67%, and 50% for filgotinib; 73%, 51%, and 44% for tofacitinib. Upadacitinib demonstrated significantly greater clinical response (<i>P</i> = .027) and remission (<i>P</i> = .037) rates at 6 months than tofacitinib. Drug persistence at 12 months was 86% for upadacitinib, 72% for filgotinib, and 69% for tofacitinib. Upadacitinib demonstrated significantly greater 6-month remission rates compared to tofacitinib in the bio-exposed cohort (71% vs 52%, <i>P</i> = .022) and in the bio-naïve cohort (93% vs 50%, <i>P</i> = .009). The incidence rates for hospital admissions were 10.2, 21.9, and 14.1 and for colectomies were 6.7, 10.0, and 5.0 per 1000 patient-months at risk for upadacitinib, filgotinib and tofacitinib, respectively.</p><p><strong>Conclusion: </strong>This study demonstrates that upadacitinib is more likely to achieve 6-month response and remission compared to tofacitinib. In both bio-naïve and bio-exposed patients, upadacitinib was more likely to achieve remission at 6 months. The efficacy of JAKi does not appear diminished by prior biologic use.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag045"},"PeriodicalIF":1.8,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249576","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":"Effectiveness and safety of extended upadacitinib induction therapy in adult patients with moderate-to-severe active ulcerative colitis.","authors":"Nabil El Hage Chehade, Tara Alleyasin, Bonnie Zagorski, Thien Nguyen, Nirmal Patel, Melissa Ferrari, Emily Singh, Mazer Ally, Rebecca Matro, Gauree G Konijeti","doi":"10.1093/crocol/otag044","DOIUrl":"10.1093/crocol/otag044","url":null,"abstract":"<p><strong>Background: </strong>Responses to induction therapies for moderate-to-severe active ulcerative colitis (UC) are sufficient, but some patients benefit from prolonged induction to achieve clinical outcomes before transitioning to maintenance dosing. Upadacitinib (UPA), an oral JAK1 inhibitor, is approved in the USA for treatment of moderate-to-severe active UC non-responsive to anti-TNF therapy. However, standard 8-week induction regimen with UPA 45 mg/day may not be sufficient for some patients. We aimed to assess the effectiveness and safety of extended UPA induction for moderate-to-severe active UC.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of adults with moderate-to-severe active UC who received UPA 45 mg/day beyond 8 weeks' induction. Patients with disease-related complications and those lost-to follow-up data after extended induction were excluded. Primary endpoint was clinical response (partial Mayo score (PMS) reduction by ≥ 3). Secondary endpoints included clinical remission (PMS ≤ 2), endoscopic response (Mayo endoscopic score decrease by ≥ 1), improvement in fecal calprotectin (FC) to <150 ug/dL, and specific adverse events.</p><p><strong>Results: </strong>Nine patients were included for analysis. All patients previously failed ≥ 1 biologic therapy, and 5 failed ≥ 2 biologic therapies, of which 1 also failed tofacitinib. Duration of extended UPA induction ranged from 12-24 weeks. Clinical response rate was 78% (7/9) and FC improved to <150 ug/dL in 71% (5/7). At the time of this report, 3 patients completed 12 weeks UPA induction but have not yet transitioned to maintenance therapy. Of these, 1 achieved clinical response, 1 achieved clinical remission, and 1 has planned colectomy for steroid-refractory UC. Five patients completed UPA extended induction (range 12-24 weeks) and transitioned to UPA 30 mg/day with stable clinical remission and FC <150 ug/g. Finally, 1 patient discontinued UPA induction after 16 weeks due to non-response and underwent total proctocolectomy. Adverse events included dental abscess (<i>n</i> = 1) and mild COVID-19 infection (<i>n</i> = 2). No patients developed Herpes zoster, VTE, or MACE.</p><p><strong>Conclusion: </strong>Our retrospective study suggests extended UPA induction, from 12-24 weeks, is effective in achieving clinical response/remission in patients with moderate-to-severe active UC with a tolerable safety profile. Our clinical response/remission rates are higher than that reported for extended induction in the U-ACCOMPLISH/U-ACHIEVE clinical trials. Larger studies and longer-term follow-up are needed to examine the efficacy and safety of this approach.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag044"},"PeriodicalIF":1.8,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276325","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":"Correction to: Patients' attitudes to disease prevention in inflammatory bowel disease: a US-based survey.","authors":"","doi":"10.1093/crocol/otag043","DOIUrl":"https://doi.org/10.1093/crocol/otag043","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/crocol/otag004.].</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag043"},"PeriodicalIF":1.8,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13192354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013852","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":"A real-world observational study of second-line anti-TNFα treatment in patients with ulcerative colitis who received vedolizumab as a first-line biologic.","authors":"Chiahung Chou, Marie Sanchirico, Precious A Anyanwu, Lucinda J Van Anglen, Timothy E Ritter","doi":"10.1093/crocol/otag042","DOIUrl":"10.1093/crocol/otag042","url":null,"abstract":"<p><strong>Background: </strong>Many patients with ulcerative colitis (UC) require treatment with more than one biologic during their lifetime. This real-world observational study assessed the effectiveness of second-line anti-tumor necrosis factor α (anti-TNFα) treatment in patients with UC who had previously received vedolizumab as a first-line biologic.</p><p><strong>Methods: </strong>This retrospective study included biologic-naive adult patients with UC who were treated with vedolizumab as a first-line biologic at a large, multicenter, private gastroenterology practice in Texas, United States, between January 1, 2018, and December 31, 2020. Outcomes were assessed by partial Mayo score, not including endoscopic data.</p><p><strong>Results: </strong>In total, 260 patients received vedolizumab. Treatment was discontinued in 53 patients who then received a second-line anti-TNFα treatment. Of all patients treated with a second-line anti-TNFα treatment, 14/53 (26.4%) had a clinical response and 11/53 (20.8%) had clinical remission at 12 months. Accounting for anti-TNFα treatment discontinuations, 14/26 patients (53.8%) had a clinical response, and 11/26 patients (42.3%) had clinical remission at 12 months, respectively. In an exploratory analysis of the patients who received vedolizumab as a first-line biologic, 188/260 (72.3%) remained on treatment at 12 months and 149/188 (79.3%) of them had clinical remission. For those with a partial Mayo score ≥ 5 at baseline, onset of vedolizumab action was observed in 49.6% by week 2 and in 87.2% by week 6.</p><p><strong>Conclusions: </strong>Second-line anti-TNFα treatments were effective following vedolizumab as a first-line biologic. Most patients had onset of action of vedolizumab within 6 weeks and had clinical remission at 12 months.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag042"},"PeriodicalIF":1.8,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137064","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 low versus high dose upadacitinib as maintenance treatment in patients with ulcerative colitis: a real-world cohort study from the United States.","authors":"Priya Sehgal, Gursimran S Kochhar, Harpreet Kaur, Himsikhar Khataniar, Raina Shivashankar, James D Lewis, Aakash Desai","doi":"10.1093/crocol/otag028","DOIUrl":"10.1093/crocol/otag028","url":null,"abstract":"<p><strong>Background: </strong>There is limited real-word data comparing efficacy of low dose upadacitinib (UPA) to high dose UPA as maintenance therapy for ulcerative colitis (UC).</p><p><strong>Methods: </strong>This was a retrospective cohort study utilizing the U.S. Collaborative Network in adults ≥18 years old with UC who initiated UPA 15 mg compared to 30 mg for maintenance therapy between April 2022 and December 2023. The primary outcome was a composite of intravenous steroid use, oral steroid use, or colectomy from 12 to 60 weeks from the index UPA prescription. Propensity score matching (PSM) was performed for demographics, co-morbid conditions, laboratory, and IBD medication history. Cox proportional hazard model was used to identify predictors of failure.</p><p><strong>Results: </strong>Among 1110 patients on UPA maintenance therapy, 361 (32.5%) were on 15 mg and 749 (67.5%) were on 30 mg. After PSM, there was no difference in the composite outcome of steroid use or colectomy between the 15-mg UPA cohort versus 30 mg cohort (35.3% vs 35.6%; aHR 0.95, 0.71-1.24, <i>P</i> = .8). There was no difference in IV steroid use, oral steroid use or change in therapy between the two cohorts. There was no difference in the proportion of patients who achieved a fecal calprotectin of <250 μg/g (55.8% vs 63.5%, <i>P</i> = .33). Recent oral or IV steroid use and rheumatoid arthritis were associated with failure of both 15 mg and 30 mg UPA.</p><p><strong>Conclusion: </strong>Our study indicates that 15 mg UPA shows similar efficacy as 30 mg UPA for maintenance treatment in a subset of patients with UC.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag028"},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940463","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":"Safety of biologics and Janus kinase inhibitors in inflammatory bowel disease patients with low cardiovascular risk.","authors":"Paraj Patel, Omair Iqbal, Divyanshu Mohananey, Saffia Bajwa, Masoud Khani, Jake Luo, Daniel J Stein, Gursimran S Kochhar, Jana G Hashash, Emad Mansoor, Raymond K Cross, Preetika Sinh","doi":"10.1093/crocol/otag039","DOIUrl":"10.1093/crocol/otag039","url":null,"abstract":"<p><strong>Background: </strong>Due to underlying chronic inflammation, inflammatory bowel disease (IBD) is associated with an increased risk of major adverse cardiovascular events (MACE). There is limited data on the role of cardiovascular (CV) risk factors and IBD medications on MACE. We aim to determine the association between MACE and IBD medications in a large national cohort of IBD patients with low baseline CV risk.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study between January 1, 2015 and November 15, 2023 using the TriNetX database. Using logistic regression analysis, IBD patients exposed to biologics and small molecules were assessed for outcomes of individual and composite MACE (myocardial infarction [MI], ischemic stroke, percutaneous coronary intervention [PCI]/coronary artery bypass graft [CABG]). Outcomes were adjusted for demographics, non-advanced IBD therapies, statin use, CV risk factors, and prior history of coronary artery disease (CAD).</p><p><strong>Results: </strong>We identified 113 729 IBD patients with an average age of 42 years and low prevalence of CV risk factors (5%-6%). Anti-TNF therapy was associated with a statistically significant decreased risk of composite MACE (adjusted OR [aOR] 0.795, 95% CI, 0.670-0.930, <i>P</i> = .005) and PCI/CABG (aOR 0.56, 95% CI, 0.274-0.562, <i>P</i> = .002), and anti-integrin therapy was associated with a decreased risk of composite MACE (aOR 0.76, 95% CI, 0.580-0.980, <i>P</i> = .035). Anti-IL12/23 and JAK inhibitors showed no increased risk of MACE.</p><p><strong>Conclusions: </strong>In a cohort of young IBD patients with low CV risk, use of anti-TNF and anti-integrins is associated with a decreased risk of MACE, and there was no increased risk of MACE with JAK inhibitors.</p>","PeriodicalId":10847,"journal":{"name":"Crohn's & Colitis 360","volume":"8 2","pages":"otag039"},"PeriodicalIF":1.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013786","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}