Inflammatory Intestinal Diseases最新文献

{"title":"A Case Study of PSTPIP1-Associated Myeloid-Related Proteinemia Inflammatory Syndrome Masquerading as Inflammatory Bowel Disease.","authors":"Pongsawat Rodsaward, Keerati Kiattikunrat, Nichthida Tangnuntachai, Supranee Buranapraditkun, Jettanong Klaewsongkram","doi":"10.1159/000553249","DOIUrl":"10.1159/000553249","url":null,"abstract":"<p><strong>Introduction: </strong>PSTPIP1-associated myeloid-related proteinemia inflammatory (PAMI) syndrome is a rare autoinflammatory disorder. Systemic inflammation, cytopenia, and skin lesions are classic features, accompanied by hypercalprotectinemia and hyperzincemia. Gastrointestinal manifestations such as colitis are infrequent. We present the first case in Thailand of PAMI syndrome presenting as refractory colitis.</p><p><strong>Case presentation: </strong>A 23-year-old male presenting with adult-onset refractory colitis and a history of a teenage perianal abscess. Despite the relatively late onset of intestinal symptoms, the patient exhibited a complex clinical picture across multiple domains of inborn errors of immunity, including autoimmune hemolytic anemia, chronic neutropenia, hepatosplenomegaly, and severe cystic acne. Genetic testing revealed a PSTPIP1 mutation (E250K variant), and laboratory results showed pathognomonic hyperzincemia, confirming PAMI syndrome. Treatment with adalimumab led to significant clinical and endoscopic remission.</p><p><strong>Conclusion: </strong>PAMI syndrome should be considered a differential diagnosis in patients with atypical or refractory colitis, particularly when accompanied by systemic clues such as cytopenia, severe acne, or organomegaly. Serum zinc levels serve as a simple, cost-effective screening tool to facilitate prompt diagnosis and can function as a practical biomarker for monitoring the response to therapy.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"300-306"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678389","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 and Preliminary Clinical Outcomes of a Combined Cannabidiol and Sodium Propionate Enema in Refractory Ulcerative Proctitis: An Open-Label Pilot Study.","authors":"Timna Naftali, Assaf Stein, Hen Kayless, Sari Prutchi Sagiv","doi":"10.1159/000552842","DOIUrl":"10.1159/000552842","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with ulcerative proctitis who fail 5-aminosalicylic acid therapy often escalate to systemic immunosuppressants or biologics, which carry significant risks. IcBD-01 is a novel enema combining cannabidiol and sodium propionate, formulated to deliver local anti-inflammatory effects with minimal systemic exposure. This proof-of-concept study assessed the safety, tolerability, and preliminary efficacy of IcBD-01 in patients with mild to moderate ulcerative proctitis.</p><p><strong>Methods: </strong>Fourteen patients unresponsive to ≥3 months of mesalamine were enrolled in a prospective, open-label, single-arm 12-week trial. IcBD-01 was self-administered daily. Disease activity was assessed using the Mayo score, patient-reported outcomes (PROs), endoscopy, histology, and inflammatory markers.</p><p><strong>Results: </strong>Of 14 enrolled patients, 9 completed the study and 10 completed ≥10 weeks of treatment. In the intention-to-treat analysis, 50% met the primary endpoint (≥3-point Mayo score reduction); in the per-protocol analysis, 77% achieved this. Full Mayo scores improved from 6.8 ± 1.7 to 3.0 ± 2.5 (<i>p</i> < 0.0001), and partial scores from 4.9 ± 1.5 to 1.8 ± 2.0 (<i>p</i> < 0.001). Significant improvements were observed in PROs, VAS pain scores, and treatment satisfaction. While histological improvement (Nancy index) was not significant, reductions in ulcerated mucosal length were noted. The treatment was well tolerated, with only mild adverse events and one nontreatment-related SAE.</p><p><strong>Conclusion: </strong>In this open-label, proof-of-concept study, IcBD-01 was well tolerated and associated with clinically meaningful improvements. These hypothesis-generating findings warrant further evaluation in randomized, placebo-controlled trials.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"314-324"},"PeriodicalIF":0.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706421","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":"Clinical Presentation of EoE in Adults: A Characteristic Story!?","authors":"Ulrike von Arnim","doi":"10.1159/000553003","DOIUrl":"10.1159/000553003","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic, progressive, immune-mediated disease characterized by symptoms of esophageal dysfunction and a dense eosinophilic infiltration of the esophageal mucosa (≥15 eosinophils/high-power field or ≥60 eosinophils/mm²). The diagnosis requires the exclusion of other local or systemic causes of esophageal eosinophilia. EoE is frequently associated with atopic disorders, including asthma, allergic rhinitis, and atopic dermatitis, reflecting its complex immunopathogenesis.</p><p><strong>Summary: </strong>Adults with active EoE may present with a broad spectrum of symptoms, most commonly dysphagia and food impaction, the latter often requiring urgent endoscopic intervention. Endoscopy plays a central role in both the diagnosis and monitoring of EoE. Although endoscopic appearances may vary, characteristic findings include edema, esophageal rings, whitish exudates, linear furrows, and strictures. These features are systematically assessed using the Endoscopic Reference Score (EREFS), which provides a standardized measure of endoscopic disease activity and severity. Recognition of these clinical manifestations and endoscopic abnormalities is essential for accurate diagnosis, disease assessment, and therapeutic management.</p><p><strong>Key messages: </strong>EoE is a chronic inflammatory esophageal disorder with distinct clinical and endoscopic manifestations. Dysphagia and food impaction are the hallmark symptoms in adults, while endoscopic evaluation remains indispensable for diagnosis and follow-up. The use of standardized scoring systems such as EREFS improves the assessment of disease activity and facilitates consistent monitoring. Early recognition of clinical symptoms and characteristic endoscopic findings is critical for optimizing patient care and preventing long-term complications.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"307-312"},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697364","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":"Management of Ulcerative Colitis after Mesalamine-Induced Myocarditis: Successful Treatment with Upadacitinib - A Case Report.","authors":"Taro Tanaka, Takatoshi Nakashima, Mitsuo Kinugasa","doi":"10.1159/000552962","DOIUrl":"10.1159/000552962","url":null,"abstract":"<p><strong>Introduction: </strong>Mesalamine intolerance occurs in 5-10% of patients with ulcerative colitis (UC), while myocarditis is an extremely rare but potentially fatal complication. Optimal UC management after mesalamine-induced myocarditis remains unclear.</p><p><strong>Case presentation: </strong>A man in his 30s with left-sided UC developed mesalamine-induced myocarditis 3 weeks after treatment initiation, confirmed by elevated troponin T, reduced ejection fraction (23%), and a positive drug-induced lymphocyte stimulation test. Cardiac function improved with corticosteroids; however, UC relapsed during steroid tapering. After multidisciplinary discussion and shared decision-making, upadacitinib was selected considering potential cardiac risk with anti-TNF therapy and the need to minimize corticosteroid exposure. Rapid clinical improvement was observed, and complete mucosal healing (Mayo endoscopic subscore 0) was confirmed at 6-month follow-up colonoscopy.</p><p><strong>Conclusion: </strong>This is the first reported case of UC complicated by mesalamine-induced myocarditis successfully treated with upadacitinib. Janus kinase inhibitors may represent a therapeutic option when conventional biologics are unsuitable in patients with severe mesalamine intolerance.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"295-299"},"PeriodicalIF":0.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653021","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":"Clinical Presentation of Eosinophilic Esophagitis in Children: A Puzzling Story.","authors":"Eleanna Stasinou, Alexandra Papadopoulou","doi":"10.1159/000552948","DOIUrl":"https://doi.org/10.1159/000552948","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder characterized by eosinophilic infiltration of the esophageal epithelium and symptoms of esophageal dysfunction. In pediatric patients, clinical presentation varies with age, ranging from gastroesophageal reflux disease-like symptoms in infants and toddlers to dysphagia and food impaction in older children and adolescents.</p><p><strong>Summary: </strong>Diagnosis is based on peak histological evidence of ≥15 eosinophils per high-power field in esophageal biopsy specimens obtained during upper endoscopy. Clinical assessment and follow-up are supported by validated tools, including the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS® v2.0) and the Pediatric Quality of Life Inventory (PedsQL™). These instruments enable evaluation of symptom severity, monitoring of disease course, and assessment of treatment response.</p><p><strong>Key messages: </strong>Pediatric EoE presents with age-dependent clinical features. Histological confirmation (≥15 eosinophils/hpf) is required for diagnosis. PEESS® v2.0 and PedsQL™ are reliable tools for clinical assessment and follow-up. Treatment aims to achieve clinical and histological remission, prevent fibrosis, and improve growth and quality of life.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"359-364"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792654","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":"Exploratory Risk Patterns of Steroid Dependency in Ulcerative Colitis: A Multicenter Pilot Study Combining Logistic Regression and Self-Organizing Map Analysis.","authors":"Yusuke Miyatani, Tetsuro Takayama, Shinji Okabayashi, Toshiyuki Endo, Tomoe Tashiro, Aya Hojo, Kunio Asonuma, Shintaro Sagami, Toshifumi Hibi, Masaru Nakano, Taku Kobayashi","doi":"10.1159/000552947","DOIUrl":"10.1159/000552947","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic corticosteroids remain widely used in ulcerative colitis (UC), yet approximately half of the initial responders relapse during tapering or soon after discontinuation (steroid dependency). Understanding patients at risk of steroid dependency may inform individualized treatment strategies. Here, we explore factors associated with steroid dependency using conventional regression analysis and an exploratory artificial neural network approach.</p><p><strong>Methods: </strong>Consecutive patients with UC who received their first course of systemic corticosteroids from May 2012 to March 2020 were retrospectively screened, and those who responded to corticosteroids at day 30 were enrolled from four institutions. Factors associated with steroid dependency were assessed by multivariable logistic regression and a self-organizing map (SOM), an unsupervised neural network. Steroid dependency was defined as clinical relapse during tapering or within 3 months after completion of corticosteroids.</p><p><strong>Results: </strong>A total of 107 patients who showed a clinical response at day 30 were analyzed. Thirty-three (30.8%) patients developed steroid dependency. In the multivariable logistic analysis, extensive colitis, initial dose of prednisolone, and two-item patient-reported outcome score at day 30 were independently associated with steroid dependency. In the SOM analysis, patients were categorized into 8 clusters with variable rates of steroid dependency, indicating heterogeneous multidimensional clinical patterns beyond those captured by conventional regression analysis.</p><p><strong>Conclusion: </strong>By combining an unsupervised SOM with conventional logistic regression, our study provided an exploratory visualization of multidimensional clinical patterns associated with steroid dependency. These findings are hypothesis-generating and require prospective validation with a larger sample size before clinical application.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"277-286"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584275","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 Case of Elderly-Onset Ulcerative Colitis with Large-Vessel Giant Cell Arteritis Treated Successfully with Tofocitinib.","authors":"Kotaro Mitsui, Yoh Ishiguro, Naoki Higuchi, Satoko Yamaguchi, Ayako Ishiguro","doi":"10.1159/000552869","DOIUrl":"10.1159/000552869","url":null,"abstract":"<p><strong>Introduction: </strong>Large-vessel vasculitis, including Takayasu arteritis and giant cell arteritis (GCA), is a recognized extraintestinal manifestation of ulcerative colitis (UC), but its optimal management remains unclear. GCA is the principal systemic vasculitis in individuals aged over 50 years, and large-vessel involvement may occur with or without cranial disease. We report a case of UC complicated by inflammation of the thoracic aorta and the proximal left subclavian and brachiocephalic arteries.</p><p><strong>Case presentation: </strong>A 78-year-old man was diagnosed with proctitis-type UC. Mesalamine was switched to rectal budesonide enema plus azathioprine owing to intolerance. One month later, fever and neck pain appeared. Continuous linear hyperintensity on T2-weighted magnetic resonance imaging extended from part of the ascending aorta through the descending aorta, involving the aortic arch and the proximal left subclavian and brachiocephalic arteries and becoming less conspicuous distally. Corresponding images of contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions with spectral pre-saturation with inversion recovery demonstrated matching mural enhancement, consistent with large-vessel GCA. Tocilizumab was administered, but UC relapsed, prompting adalimumab initiation, which later resulted in loss of response. Infliximab was attempted but was discontinued because of an infusion reaction. Prednisolone 10 mg/day resulted in improvement, and tofacitinib was introduced for steroid tapering.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering large-vessel GCA in elderly-onset UC with unexplained fever and demonstrates the potential role of tofacitinib in achieving steroid-free remission and vascular inflammation, offering a potential novel therapeutic option for refractory overlap syndromes.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"287-294"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619763","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":"Early Symptomatic Improvement Is Informing Long-Term Quality-of-Life Outcomes with Filgotinib Treatment in Ulcerative Colitis: A Post Hoc Analysis of the SELECTION and SELECTIONLTE Trials.","authors":"Fumihito Hirai, Christine Rudolph, Toshihiko Kaise, Toshifumi Hibi","doi":"10.1159/000552558","DOIUrl":"10.1159/000552558","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis is a chronic inflammatory condition of the colon that significantly impairs quality-of-life. While filgotinib (FIL) has shown long-term efficacy in improving disease-specific quality-of-life via Inflammatory Bowel Disease Questionnaire (IBDQ) total scores, its impact on individual bowel/systemic symptoms remains unclear. This post hoc analysis assessed FIL's long-term effects on these symptoms and explored factors associated with sustained remission.</p><p><strong>Methods: </strong>This analysis included 148 patients from SELECTION trial patients who completed induction and maintenance phases, enrolled in SELECTIONLTE, and continued 200-mg FIL (FIL200) without treatment change. Changes from induction baseline in IBDQ total and subscores (bowel/systemic symptoms) were assessed at Week 10, 58, and long-term extension (LTE) Week 96. Remission was defined as IBDQ ≥170 and partial Mayo Clinic Score (pMCS) ≤1 at each timepoint.</p><p><strong>Results: </strong>At Week 10, for patients with vs. without pMCS remission, the mean ± standard deviation change in IBDQ total score was 72.98 ± 39.37 vs. 53.46 ± 31.75, respectively. At Week 58, it was 80.42 ± 34.44 vs. 49.97 ± 38.24 and at LTE Week 96, it was 84.14 ± 35.22 vs. 49.10 ± 28.00, respectively. Overall, bowel and systemic symptom scores were numerically higher in patients with vs. without pMCS remission at Week 10, slightly increased at Week 58, and remained consistent at LTE Week 96. Symptomatic remission at Week 10 and IBDQ remission at LTE Week 96 were associated significantly (odds ratio [95% confidence interval]: 2.288 [1.003-5.216]; <i>p</i> = 0.049).</p><p><strong>Conclusions: </strong>FIL200 improved bowel and systemic symptoms beyond rectal bleeding and stool frequency, enhancing disease-specific quality-of-life. Week 10 symptomatic remission was marginally associated with higher odds of long-term IBDQ remission, suggesting that early symptomatic remission provides clinically relevant information on sustained quality-of-life improvement.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"270-276"},"PeriodicalIF":0.0,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584307","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 Rare Case of Ileoileal Fistula Concomitant with Adenocarcinoma in a Patient with Crohn's Disease.","authors":"Yuta Shimomori, Yoshihiro Yokoyama, Daisuke Hirayama, Hayato Nakamura, Kotaro Akita, Tomoe Kazama, Hiroki Kurumi, Kohei Wagatsuma, Hiroshi Nakase","doi":"10.1159/000552477","DOIUrl":"10.1159/000552477","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease (CD) is a chronic inflammatory bowel disease that involves any segment of the gastrointestinal tract. Fistulas are clinically challenging complications of CD. Sustained chronic inflammation in the fistulas can lead to cancer.</p><p><strong>Case presentation: </strong>A 42-year-old man diagnosed with ileocolonic CD at 18 years of age had been treated with oral mesalazine. At 23 years of age, his computed tomography (CT) results revealed an internal fistula between the ileum and sigmoid colon and ileal-ileal adhesion, with no obvious fistula. No additional treatment was administered because the activity of the patient's disease was mild. At 29 years of age, he underwent colonoscopy, which revealed narrowing of the terminal ileum due to sustained diarrhea and abdominal pain. Abdominal contrast-enhanced CT revealed ileocecal and ileoileal fistulas in addition to the existing ileosigmoid fistula. Therefore, ileocecal and ileosigmoid fistula resections were performed. Pathological examination revealed adenocarcinoma involving the ileoileal fistula. The pathological stage was pT4aNXM0, based on the <i>Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma</i>, 9th edition (2018). The patient received postoperative adjuvant chemotherapy, and no recurrence has been reported in the 4 years since surgery.</p><p><strong>Conclusion: </strong>To prevent complications such as fistulas in patients with CD, it is important to initiate early anti-inflammatory treatment. Furthermore, when managing long-term, poorly controlled internal fistulas, the potential for malignancy must be considered.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"244-249"},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404527","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 Efficacy of Ustekinumab versus Vedolizumab for Ulcerative Colitis: Differences between Short- and Long-Term Outcomes Based on Endoscopic Remission.","authors":"Makoto Furuya, Jun Kato, Ken Takeuchi, Kento Shimizu, Toshiyuki Ito, Nobuaki Shu, Yusuke Ozeki, Ryosuke Horio, Chihiro Goto, Tsubasa Ishikawa, Hirotaka Oura, Tatsuya Kaneko, Yuki Ohta, Takashi Taida, Kenichiro Okimoto, Keiko Saito, Tomoaki Matsumura","doi":"10.1159/000552373","DOIUrl":"10.1159/000552373","url":null,"abstract":"<p><strong>Introduction: </strong>Ustekinumab (UST) and vedolizumab (VED) are effective for ulcerative colitis (UC), but long-term real-world data, particularly regarding endoscopic remission, remain limited.</p><p><strong>Methods: </strong>Patients with UC who were treated with UST or VED at two tertiary centers were enrolled in this retrospective study. Baseline imbalances were adjusted using inverse probability of treatment weighting. The primary outcome was the endoscopic remission rates (Mayo Endoscopic Subscore [MES] 0 or 1 and MES 0 alone) at 1 year and 2 years. Secondary outcomes included clinical remission rates and treatment persistence.</p><p><strong>Results: </strong>Overall, 197 patients were analyzed: 96 received UST, and 101 received VED. The median observation period was 2.5 years. Clinical remission rates did not differ between the two groups. Treatment persistence was higher with UST than with VED (HR: 1.85; 95% CI: 1.13-3.02; <i>p</i> = 0.014), particularly in the early period. At 1 year, there were no significant differences in endoscopic remission rates for MES 0 or 1 and MES 0 alone between the two groups. At 2 years, patients treated with UST were significantly more likely to achieve MES 0 or 1 (UST, 45.0% vs. VED, 19.8%; OR for VED vs. UST, 0.30; 95% CI: 0.11-0.82; <i>p</i> = 0.019), whereas achievement of MES 0 alone did not differ significantly.</p><p><strong>Conclusion: </strong>UST was associated with a higher rate of achieving MES 0 or 1, while deep remission rates were comparable. This may explain a more pronounced difference in treatment persistence in the short-term phase, with the difference decreasing over time.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"11 1","pages":"250-259"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411856","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}