Inflammatory Bowel Diseases最新文献

{"title":"Five-year efficacy and safety of guselkumab for moderately to severely active Crohn's disease: Results from the phase 2 GALAXI 1 trial.","authors":"Anita Afzali, Silvio Danese, Remo Panaccione, David T Rubin, Bruce E Sands, Walter Reinisch, Julián Panés, Rian Van Rampelbergh, Nat A Terry, Leonardo Salese, Marion L Vetter, Jacqueline Yee, Christopher Corbett, Wilbert van Duijnhoven, Tadakazu Hisamatsu, Jane M Andrews, Geert R D'Haens","doi":"10.1093/ibd/izag055","DOIUrl":"10.1093/ibd/izag055","url":null,"abstract":"<p><strong>Background: </strong>The randomized, phase 2 GALAXI 1 study evaluated efficacy and safety of guselkumab, a dual-acting IL-23p19 subunit inhibitor, in participants with moderately to severely active Crohn's disease. Efficacy and safety through 5 years are reported.</p><p><strong>Methods: </strong>After completing the 48-week, treat-through GALAXI 1 main study, participants could enter the long-term extension (LTE) and continue the subcutaneous maintenance regimen assigned at randomization. Efficacy for the combined guselkumab dose groups was analyzed by (1) as-observed analysis of LTE participants, (2) nonresponder imputation (NRI) analysis of LTE participants, and (3) NRI analysis of primary efficacy analysis set (all [week 0] randomized participants). The study was not designed for statistical comparisons between groups.</p><p><strong>Results: </strong>Of 185 guselkumab-randomized participants in the primary efficacy analysis set, 151 participated in the LTE. Among those continuing treatment, with available data (as observed), 97.7% (n = 85 of 87) achieved clinical remission, 71.3% (n = 62 of 87) achieved endoscopic response, and 51.7% (n = 45 of 87) achieved endoscopic remission at week 240. Results from NRI analyses also showed durability of efficacy (eg, week-240 clinical remission: 59.2% [n = 84 of 142], LTE analysis set; 46.0% [n = 81 of 176], primary efficacy analysis set). High rates of clinical and endoscopic remission at week 240 were maintained in biologic-naive participants (97.8% [n = 45 of 46] and 54.3% [n = 25 of 46], respectively [as-observed]) and participants with an inadequate response or intolerance to biologic therapy (97.1% [n = 34 of 35] and 54.3% [n = 19 of 35], respectively [as-observed]). Event rates of serious adverse events, discontinuations due to adverse events, and serious infections were low in guselkumab-treated participants.</p><p><strong>Conclusions: </strong>Long-term guselkumab treatment showed sustained clinical and endoscopic efficacy through week 240. The long-term safety data were consistent with those previously presented in approved indications.</p><p><strong>Clinical trial registration: </strong>A Study of the Efficacy and Safety of Guselkumab in Participants With Moderately to Severely Active Crohn's Disease (GALAXI), NCT03466411, https://clinicaltrials.gov/study/NCT03466411.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1669-1682"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early transmural response assessed by intestinal ultrasound predicts long-term clinical remission in patients with IBD: Results from the TRUST BEYOND study.","authors":"Torsten Kucharzik, Ulf Helwig, Frank Seibold, Luc Biedermann, Christoph Högenauer, Imma Fischer, Leonie Hammer, Stefan Rath, Christian Maaser","doi":"10.1093/ibd/izag074","DOIUrl":"10.1093/ibd/izag074","url":null,"abstract":"<p><strong>Background: </strong>The study sought to prospectively examine clinical, biochemical, and transmural outcomes. Transmural outcomes are assessed by ultrasound after 1 year in patients with inflammatory bowel disease (IBD) treated in line with standard of care.</p><p><strong>Methods: </strong>The TRUST BEYOND study is a prospective, multicenter, noninterventional study at 49 sites in Germany, Austria, and Switzerland and includes 282 patients with IBD who have active disease at baseline. For this analysis, 163 patients with IBD (74 with Crohn's disease, 89 with ulcerative colitis) were followed up for 1 year. At baseline and at every 3 months, clinical, biochemical, and ultrasound parameters, such as bowel wall thickness and color Doppler sonography, were assessed.</p><p><strong>Results: </strong>Patients with IBD demonstrated vast improvements in clinical, biochemical, and ultrasound assessments as early as week 12. Rates of transmural response and healing progressively increased over the study period to up to 77.5% and 39.3%, respectively, in patients with ulcerative colitis and to 66.2% and 27.0%, respectively, in patients with Crohn's disease. Patients with early transmural response achieved numerically higher rates of various outcomes at week 52 than patients without early transmural response. In a multivariate analysis, transmural response at week 12 predicted clinical remission at week 52 (odds ratio, 4.3; 95% confidence interval, 2.45-7.52; P < .001).</p><p><strong>Conclusions: </strong>These results suggest that intestinal ultrasound is a suitable noninvasive modality to monitor patients with IBD in routine care. Transmural endpoints can be achieved in patients with IBD treated with standard of care and can predict outcomes after 1 year.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1770-1782"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of surgical recurrence after primary ileocolic resection in Crohn ileitis: a systematic review and meta-analysis.","authors":"Anouck E G Haanappel, Eline M L van der Does de Willebois, Mahsoem Ali, Faridi S Jamaludin, Marjolijn Duijvestein, Christianne J Buskens, Willem A Bemelman, E Joline de Groof","doi":"10.1093/ibd/izag037","DOIUrl":"10.1093/ibd/izag037","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment strategies for Crohn disease (CD) have evolved considerably over recent decades. Approximately 65% of primary resections for CD comprise ileocolic resections (ICR). Currently, up-to-date data are not available on surgical recurrence risk after primary ICR, as previous meta-analyses combined various types of intestinal resections. As such, we aimed to assess the incidence, predictors, and trends of surgical recurrence after primary ICR for CD.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, and the Cochrane database were searched from inception until November 15, 2023. Studies were included if they described the surgical recurrence risk after a primary ICR for CD. The primary endpoint was surgical recurrence, defined as reoperation due to disease recurrence in the neoterminal ileum. Meta-analyses were performed to (1) evaluate trends in surgical recurrence over time, (2) estimate the risk of surgical recurrence in the biologics era (post-2000), and (3) identify risk factors for surgical recurrence.</p><p><strong>Results: </strong>Among 3498 articles screened, 55 were included, of which 31 studies reported cumulative 5- and/or 10-year surgical recurrence rates (study inclusion period: 1932-2020; n = 28 354 patients). Meta-regression analysis indicated a declining trend in both 5- and 10-year surgical recurrence rates, which stabilized after 2000. In the biologics era, pooled 5- and 10-year surgical recurrence risks were 5.7% (95% CI, 3.9-8.4) and 13.0% (8.3-19.7), respectively. Smoking, patient sex, perianal disease, and behavior were not significantly prognostic for surgical recurrence after primary ICR.</p><p><strong>Conclusion: </strong>Approximately 1 in 17 patients experience surgical recurrence within 5 years after primary ICR. The risk of surgical recurrence decreased over the past decades but has stabilized in the biologics era.</p><p><strong>Systematic review registration: </strong>PROSPERO registration No. CRD42020213027.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1815-1832"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor: \"GLP-1RAs for pouchitis in obesity: what the current study does not tell us\".","authors":"Hany Habib, Aakash Desai","doi":"10.1093/ibd/izag128","DOIUrl":"10.1093/ibd/izag128","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1868-1869"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic disparities in biologic persistence among patients with inflammatory bowel disease are associated with increased health care utilization.","authors":"Jessica L Sheehan, Dala Eloubeidi, Kira L Newman, Laura A Johnson, Ariel A Jordan, Shirley Cohen-Mekelburg, Jeffrey A Berinstein, Renuka Tipirneni, Peter D R Higgins","doi":"10.1093/ibd/izag062","DOIUrl":"10.1093/ibd/izag062","url":null,"abstract":"<p><strong>Introduction: </strong>Biologic persistence, defined as the total uninterrupted time on a biologic agent, is associated with improved outcomes in inflammatory bowel disease (IBD). However, social determinants of health (SDOH), such as socioeconomic status, may influence a patient's ability to access these medications. We aimed to better understand the relationship between socioeconomic status and biologic persistence in patients with IBD and to determine whether patients with poor biologic persistence had higher health care utilization.</p><p><strong>Methods: </strong>We identified patients with IBD seen at the University of Michigan during 2015-2022. Using the Centers for Disease Control Social Vulnerability Index (SVI), we examined the relationship between socioeconomic status and biologic persistence, defined as an active biologic prescription for 365 days or longer, while controlling a priori for IBD type, age, sex, race, comorbidities, IBD severity, and insurance type. Secondarily, we examined the relationship between biologic persistence and unplanned health care utilization.</p><p><strong>Results: </strong>In this cohort of 3067 patients with IBD who were prescribed biologics, 20% (n = 620) did not achieve biologic persistence. Low socioeconomic status (odds ratio [OR] 0.56; P = .003) was associated with a lower likelihood of achieving biologic persistence. Biologic persistence was associated with lower risk of IBD-related hospitalization (incidence rate ratio [IRR], 0.48; P < .001), readmission (IRR, 0.52; P < .001), and surgery (IRR, 0.33; P < .001).</p><p><strong>Conclusions: </strong>Low socioeconomic status was associated with lower likelihood of biologic persistence and patients who lacked biologic persistence had greater IBD-related unplanned health care utilization.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1741-1749"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond calprotectin: where leucine-rich α2-glycoprotein may fit in small bowel Crohn's disease monitoring.","authors":"Tatsuya Kawamura, Takeshi Yamamura, Masanao Nakamura","doi":"10.1093/ibd/izag175","DOIUrl":"https://doi.org/10.1093/ibd/izag175","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of nutritional status and energy expenditure in relation to dietary intake in hospitalized and outpatient patients with inflammatory bowel disease across disease phases.","authors":"Tessa C Oude Vrielink, Peter B F Mensink, Inge Oude Meijers, Marita Klein Jäger, Job van der Palen, Henri Braat, Wouter Tobias van Haaften","doi":"10.1093/ibd/izag171","DOIUrl":"https://doi.org/10.1093/ibd/izag171","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a common problem in inflammatory bowel diseases (IBD) and is associated with poorer outcomes and reduced quality of life. Body mass index (BMI) is commonly used to assess nutritional status but does not reflect body composition. Data on nutritional status and energy requirements in IBD are limited. The aim of our study was to evaluate nutritional status and energy requirements in hospitalized and outpatient patients with active IBD, and in patients with IBD in remission, in relation to caloric and protein intake.</p><p><strong>Methods: </strong>This single-center prospective cohort study assessed nutritional status using the fat-free mass index (FFMI), derived from bioelectrical impedance vector analysis (BIVA). Energy requirements were measured by indirect calorimetry (Q-NRG). Protein requirements and caloric and protein intake were evaluated. Active IBD patients were evaluated longitudinally at baseline and 12 weeks and compared cross-sectionally with patients in remission.</p><p><strong>Results: </strong>Following remission, FFMI increased by 1.1 kg/m² in hospitalized patients (n = 14), significantly greater than the 0.4 kg/m² increase in outpatients (n = 12) (P = .026). No significant differences were observed between groups in BMI change (P = .45) or resting energy expenditure reduction (P = .53). Once in remission, the caloric balance of hospitalized and outpatient patients were comparable to patients with IBD in remission (n = 11) (P = .66).</p><p><strong>Conclusions: </strong>Hospitalized patients with active IBD showed greater improvement in BIVA-derived nutritional status during remission than outpatients, despite similar BMI changes and stable energy expenditure. BIVA-derived FFMI may be useful for nutritional assessment of patients with IBD. Given the small sample size and exploratory design, these results should be interpreted as hypothesis-generating.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable perspiration sensor for continuous inflammation tracking in inflammatory bowel disease.","authors":"Sarah Shahub, Kai-Chun Lin, Natalie K Choi, Nicole M Garcia, Sriram Muthukumar, David T Rubin, Shalini Prasad","doi":"10.1093/ibd/izag173","DOIUrl":"https://doi.org/10.1093/ibd/izag173","url":null,"abstract":"<p><strong>Background: </strong>Wearable sensors present an opportunity to monitor inflammation via noninvasive media such as perspiration, which may be sampled continuously to track biomarkers in inflammatory bowel disease (IBD). Here we demonstrate the use of a perspiration sensor for C-reactive protein (CRP) and calprotectin and their clinical significance.</p><p><strong>Methods: </strong>Thirty-three patients with IBD were enrolled in a cross-sectional study of CRP and calprotectin perspiration expression compared to expression in serum and stool, respectively. Perspiration on-body measurements were obtained every minute using a wearable sensor worn for 40-130 minutes during standard of care assessment. Synchronously collected serum levels were measured, as was fecal calprotectin from a subcohort.</p><p><strong>Results: </strong>Principal component analysis of demographic data identified age, disease activity, and diagnosis as the major contributors to variance in the dataset. When endoscopic scores were incorporated into the PCA, both disease activity and endoscopy score were identified as contributing most strongly to the primary variance. In perspiration and serum, median CRP was observed to be elevated in patients with Crohn's disease (CD) compared to ulcerative colitis, while median calprotectin was elevated in UC compared to CD. Median calprotectin across perspiration, serum, and stool was observed to be elevated in IBD of the colon over isolated ileal IBD. Furthermore, median perspiration and serum CRP were elevated in patients under 40 years of age compared to those 40 and older, whereas median perspiration, serum, and fecal calprotectin were elevated in patients 40 and older compared to the younger cohort.</p><p><strong>Conclusions: </strong>We report the use of a noninvasive perspiration sensor for tracking inflammatory markers in patients with IBD and demonstrate consistency of perspiration CRP and calprotectin measurements with corresponding serum and stool measurements.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting and representation of participant race, ethnicity, and sex in pediatric IBD clinical trials.","authors":"Yunlin Jiang, Jiaying Tan, Long Qin, Mingye Zhao, Zhenyi Wang","doi":"10.1093/ibd/izag169","DOIUrl":"https://doi.org/10.1093/ibd/izag169","url":null,"abstract":"<p><strong>Background and aims: </strong>Pediatric inflammatory bowel disease (IBD) incidence is rising among racial and ethnic minority children, yet to our knowledge no comprehensive evaluation of demographic representation in pediatric IBD trials exists. We systematically evaluated the reporting and representation of race, ethnicity, and sex in pediatric IBD clinical trials, stratified by Crohn disease (CD) and ulcerative colitis (UC).</p><p><strong>Methods: </strong>We performed a cross-sectional study of pediatric IBD trials identified in PubMed and EMBASE through March 2026. Reference distributions were derived from the National Patient-Centered Clinical Research Network (race/ethnicity, United States) and the Global Burden of Disease Study 2023 (sex, global). Enrollment incidence ratios (EIRs) were used to compare trial enrollment to expected disease burden. Comparisons were performed with random-effects meta-analyses that pooled trial-level estimates, with subgroup analyses, sensitivity analyses, and meta-regression analyses.</p><p><strong>Results: </strong>Of 145 trials enrolling 8273 children, sex and race were consistently reported; ethnicity reporting rose from 0% before 2000 to 87.5% after 2020. Female participants were underrepresented (EIR, 0.91; 95% CI, 0.87-0.95), most markedly in CD trials (EIR, 0.82; 95% CI, 0.78-0.88). Black (EIR, 0.55; 95% CI, 0.42-0.71) and Hispanic (EIR, 0.46; 95% CI, 0.28-0.76) participants were underrepresented. Asian/Pacific Islander participants were overrepresented (EIR, 1.78; 95% CI, 1.37-2.30), while White and non-Hispanic participants were proportionally represented. Meta-regression showed gains over time for Asian/Pacific Islander, female, and Hispanic participants, but a slight decline for Black participants.</p><p><strong>Conclusions: </strong>Female and Black children remain persistently underrepresented in pediatric IBD trials relative to disease burden; findings for Hispanic children were similar but based on a small number of trials. Enforceable diversity action plans and standardized demographic reporting are urgently needed to ensure equitable therapeutic benefit.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the TL1A pathway in inflammatory bowel disease: mechanistic insights and emerging therapeutic pipeline.","authors":"Mohammed Nabil Quraishi, Vipul Jairath, Badr Al-Bawardy","doi":"10.1093/ibd/izag172","DOIUrl":"https://doi.org/10.1093/ibd/izag172","url":null,"abstract":"<p><p>Tumor necrosis factor-like ligand 1A (TL1A), encoded by TNFSF15, signals through death receptor 3 on effector T cells, innate lymphoid cells, and intestinal myofibroblasts, driving both chronic intestinal inflammation and tissue fibrosis. In this narrative review, we provide a contemporary appraisal of TL1A-directed therapeutics in inflammatory bowel disease based on electronic searches through May 2026. Three anti-TL1A monoclonal antibodies (tulisokibart, afimkibart, and duvakitug) have advanced to phase 3 trials across multiple global programs, with phase 2 clinical remission rates of 26%-48% in ulcerative colitis (placebo-adjusted differences 15-26 percentage points) and endoscopic response rates of 26%-48% in Crohn's disease, alongside favorable safety profiles. Mucosal transcriptomic and serum proteomic analyses from phase 2 trials, including DDW 2026 readouts from ARTEMIS-UC and TUSCANY-2, provide the first human-tissue confirmation of class antifibrotic activity through the suppression of Th17, myeloid, and extracellular matrix pathways. TNFSF15 risk-variant companion diagnostics are advancing, although their incremental utility remains modest and will be definitively tested in phase 3. The pipeline has expanded to at least 19 development programs, including extended half-life antibodies (XmAb942, SPY002, and BCD-261), bispecifics combining TL1A with IL-23 or α4β7 (RO7837195, XmAb412, LQ080, and ALX001), a first-in-class oral anti-TL1A nanobody, and a first-in-class DR3 receptor antagonist (SL-325). We discuss therapeutic positioning and timing, the opportunity in acute severe UC, and the unusual standing of IBD as the lead indication for this mechanism class. Phase 3 results anticipated in 2026-2027 will be particularly informative for fibrostenotic phenotypes and biologic-refractory patients.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}