Inflammatory Bowel Diseases最新文献

{"title":"Comparative efficiency of leucine-rich alpha-2 glycoprotein and fecal calprotectin to assess endoscopic activity in Crohn's disease: a prospective observational study.","authors":"Tatsuya Kawamura, Takeshi Yamamura, Masanao Nakamura, Keiko Maeda, Tsunaki Sawada, Eri Ishikawa, Kentaro Murate, Takashi Hirose, Takuya Ishikawa, Kazuhiro Furukawa, Takashi Honda, Muneyori Okita, Hiroki Kawashima","doi":"10.1093/ibd/izag105","DOIUrl":"10.1093/ibd/izag105","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic healing is a key therapeutic target for Crohn's disease (CD). However, endoscopy is invasive, and simple, non-invasive biomarkers are needed to assess endoscopic healing. Although leucine-rich alpha-2 glycoprotein (LRG) and fecal calprotectin (FC) are indicators of inflammatory bowel disease activity, few studies have directly compared them for endoscopic disease activity in CD. We aimed to compare the ability of these markers to assess endoscopic remission in CD.</p><p><strong>Methods: </strong>From October 2022 to December 2023, 100 patients with CD at Nagoya University Hospital were prospectively and consecutively enrolled. Endoscopic activity was assessed using the applied simple endoscopic score for Crohn's disease (aSES-CD), incorporating small bowel lesions. The primary endpoint was the sensitivity of LRG and FC in endoscopic remission (aSES-CD ≤ 3), which was tested using McNemar's exact test. Logistic regression analysis was used to identify factors associated with endoscopic remission.</p><p><strong>Results: </strong>Overall, 84 patients were analyzed (79.8% male; median age 49.5 years). The receiver operating characteristic curve analysis yielded sensitivity/specificity values of 85.9%/90.0% for LRG and 70.3%/85.0% for FC, using cutoff values of 11 µg/mL (LRG) and 100 µg/g (FC) for endoscopic remission. Based on these values, a comparison of sensitivities between LRG and FC showed that LRG had significantly higher sensitivity (P = .013). In multivariate analysis, only LRG was an independent factor for endoscopic remission (odds ratio 3.016; 95% CI, 1.506-6.037).</p><p><strong>Conclusions: </strong>Compared with FC, LRG shows a higher sensitivity for assessing endoscopic remission. LRG may serve as a useful biomarker for endoscopic activity in CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1969-1979"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258119","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":"Readability and quality of online inflammatory bowel disease pregnancy resources.","authors":"Laxmikausthubha Yaratha, Anushka Deogaonkar, Pavan Vemulakonda, Sudharshan Raajkumar Ezhil, Marie Borum","doi":"10.1093/ibd/izag153","DOIUrl":"10.1093/ibd/izag153","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2084"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669377","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":"Distinct predictive factors for acute severe ulcerative colitis in East Asian and Western populations.","authors":"Eun Soo Kim, Dong Hyun Kim, Seong-Jung Kim, Sang Hyoung Park, Hyun Seok Lee, Sung Kook Kim, Hyun Soo Kim, Jun Lee, Kyeong Ok Kim, Byung Ik Jang, Yoo Jin Lee, Eun Mi Song, Dae Sung Kim, Chun-Chi Lin, Joyce Wing Yan Mak, Jing Liu, Qian Cao, Shu-Chen Wei, Wei-Chen Lin, Wen-Hung Hsu, Shintaro Sagami, Taku Kobayashi, Richard G Fernandes, Robert Gilmore, Yoon-Kyo An, Jakob Begun, Katie Rice, Leonie Ruddick-Collins, Abhinav Vasudevan, Jennifer Zhang, Anthony Brownson, Benjamin Ngoi, Kate Lynch, Craig Haifer, Lucy Mary Lilian Bracken, Ei Swe, Emily Wright, Nicholas Clark, Tamar Schildkraut, Gillian Mahy, Gregory Moore, Kathryn Gazelakis, Mayur Garg, Michael Schultz","doi":"10.1093/ibd/izag098","DOIUrl":"10.1093/ibd/izag098","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop predictive models for acute severe ulcerative colitis (ASUC) using data from East Asian (EA) patients and to validate their performance in an Australia/New Zealand (ANZ) cohort.</p><p><strong>Methods: </strong>A retrospective international study was conducted across 23 referral hospitals in EA and ANZ, enrolling consecutive ASUC patients between January 2015 and December 2022. Logistic regression analyses were used to construct predictive models for 1-year colectomy and non-response to corticosteroid therapy (NRS).</p><p><strong>Results: </strong>Overall, 826 patients with ASUC were included (411 EA and 415 ANZ). Among EA patients, independent predictors of 1-year colectomy included female sex, prior exposure to tumor necrosis factor inhibitors, and admission albumin ≤3 g/dL. Independent predictors of NRS in the EA cohort were age at diagnosis  ≤37 years, baseline steroid use, admission albumin ≤2.5 g/dL, and the presence of extraintestinal manifestations. The EA-derived scoring systems demonstrated strong predictive performance within the EA cohort (1-year colectomy: P < .0001; NRS: P = .001) but showed limited utility in the ANZ cohort (P = .106 and P = .012). In contrast, European-developed models-including the French 1-year colectomy score and the ADMIT-ASC index for NRS-accurately predicted outcomes in the ANZ cohort (P = .007 and P < .0001) but had reduced predictive capacity in the EA cohort (P = .106 and P = .026). These findings were consistent in both cohorts following propensity score matching.</p><p><strong>Conclusions: </strong>Predictive factors for ASUC differ substantially between EA and ANZ patients, highlighting the need for population-specific predictive tools.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1957-1968"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162783","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":"Disease phenotype affects treatment of late-onset inflammatory bowel disease: Analysis of a large UK cohort.","authors":"Peter F G Foulser, Laura Martinez-Gili, Sharmili Balarajah, Rohan Sundramoorthi, James L Alexander, Benjamin H Mullish, Julian R Marchesi, Miles Parkes, Timothy R Orchard, Lucy C Hicks, Horace R T Williams","doi":"10.1093/ibd/izag072","DOIUrl":"10.1093/ibd/izag072","url":null,"abstract":"<p><strong>Background: </strong>The incidence of inflammatory bowel disease (IBD) in older adults is rising. Studies of late-onset (LO) (diagnosis  ≥60 years of age) IBD are contradictory, with some suggesting increased use of corticosteroid and reduced use of advanced therapies. This multicenter study assessed disease phenotype and therapeutic choice in LO-IBD.</p><p><strong>Methods: </strong>Patients recruited to the NIHR IBD BioResource with LO ulcerative colitis (UC) or Crohn's disease (CD) were compared with those with young-onset (YO) (16-39 years of age) and mid-onset (MO) (40-59 years of age) IBD. Medication use and surgeries were assessed in propensity score-matched cohorts.</p><p><strong>Results: </strong>A total of 32 012 patients were studied: 16 930 UC (2247 LO) and 15 082 CD (1409 LO). LO-UC was mostly left-sided, with less isolated proctitis. LO-CD patients had less ileocolonic and perianal disease. Corticosteroid, immunomodulator, and anti-tumor necrosis factor α (anti-TNF) use was lower in LO-UC and LO-CD; however, there was no difference in time to colectomy (LO-UC) or intestinal resection (LO-CD) compared with younger patients. LO-CD patients were more likely to receive vedolizumab and ustekinumab than YO-CD (odds ratio, 0.34 [95% confidence interval, 0.18-0.61] and 0.29 [95% confidence interval, 0.09-0.76], respectively). LO patients with perianal CD were less likely to receive anti-tumor necrosis factor or undergo perianal surgery than YO and MO patients with perianal CD (all P < .01).</p><p><strong>Conclusions: </strong>LO-IBD has a distinct phenotype, with less isolated proctitis (LO-UC) and less ileocolonic and perianal CD. LO-IBD patients had lower corticosteroid, immunomodulator, and anti-tumor necrosis factor use but equivalent colectomy and intestinal resection rates. LO-CD is notable for the higher use of vedolizumab and ustekinumab, suggesting that age, comorbidity, and disease phenotype affect biologic choice in older adults. Research to understand whether differential treatment of older adults is justified is crucial.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1888-1897"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837414","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":"Transperineal contrast-enhanced ultrasound: a rapid and reliable tool for differentiating abscesses from inflammatory masses in perianal Crohn's disease.","authors":"Giovanni Maconi, Cristina Bezzio, Adam Saleh, Sofia Silva Mendes, Federica Lepore, Bincy P Abraham, Dan Carter","doi":"10.1093/ibd/izag089","DOIUrl":"10.1093/ibd/izag089","url":null,"abstract":"<p><strong>Background and aim: </strong>Perianal abscesses are serious complications of Crohn's disease (CD) requiring timely and accurate diagnosis. Contrast-enhanced ultrasound (CEUS), which in abdominal intestinal ultrasound (IUS) has shown diagnostic performance comparable to CT/MRI in distinguishing intra-abdominal abscesses from inflammatory masses, has not been systematically evaluated in the transperineal assessment of perianal Crohn's disease. This study aimed to evaluate the diagnostic performance, inter- and intra-observer agreement, and diagnostic confidence of transperineal CEUS versus conventional B-mode TPUS in CD patients with perianal symptoms and suspected septic complications.</p><p><strong>Methods: </strong>We retrospectively reviewed 52 examinations of 37 adult CD patients presenting with painful perianal symptoms and suspected septic complications. Patients were included if TPUS detected lesions > 10 mm requiring CEUS characterization. Exclusion criteria were CEUS contraindications, simple fistulas, or large (>3 cm) obvious abscesses. All examinations were recorded, and three blinded experts independently assessed anonymized videos in random order. Lesions were classified as abscesses, inflammatory masses, or phlegmons. Agreement for lesion size, fluid content, and final diagnosis was evaluated using intraclass correlation coefficients (ICC) and Fleiss-Cohen's kappa (κ). Diagnostic confidence was assessed using a 5-point Likert scale.</p><p><strong>Results: </strong>On B-mode, 17 abscesses, 32 inflammatory masses, and 3 phlegmons were identified. CEUS reclassified several, yielding 16 abscesses, 31 inflammatory masses, and 5 phlegmons. Of the 17 abscesses diagnosed on B-mode, only 4 were also classified as abscesses on CEUS, while 13 were reclassified; conversely, 11 inflammatory masses were reclassified as abscesses. Intra-observer reliability improved from κ = 0.55 with B-mode to κ = 0.95 with CEUS. Inter-observer agreement for diagnosis was poor with B-mode (κ = 0.31) but excellent with CEUS (κ = 0.83).</p><p><strong>Conclusions: </strong>Transperineal CEUS significantly improves inter- and intra-observer agreement and diagnostic confidence compared with conventional B-mode TPUS when differentiating perianal abscesses from inflammatory masses/phlegmons in CD and frequently leads to lesion reclassification in clinically ambiguous cases.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1928-1936"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029858","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":"Pediatric bowel-wall thickness cutoffs: calibration before implementation.","authors":"Yi Luo, Chao-Chi Yue","doi":"10.1093/ibd/izag131","DOIUrl":"10.1093/ibd/izag131","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"2078-2079"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351950","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":"Multi-modal ensemble learning prediction of anti-TNF treatment response in pediatric patients with Crohn's disease using clinical, radiomic, and deep learning MR enterography features.","authors":"Hailong Li, Zhixiu Lu, Nicholas Denson, Wen Pan, Julia Smith, Ryan Murphy, Emily R Miraldi, Alexander G Miethke, Jasbir Dhaliwal, Lee A Denson, Lili He, Jonathan R Dillman","doi":"10.1093/ibd/izag156","DOIUrl":"10.1093/ibd/izag156","url":null,"abstract":"<p><strong>Background: </strong>Anti-tumor necrosis factor (TNF) medical therapy is a major advancement for Crohn's disease (CD) management, yet many patients fail to respond. This study aims to develop and evaluate a multi-modal ensemble model to predict anti-TNF treatment response in pediatric patients with CD using pre-treatment magnetic resonance enterography (MRE) and non-imaging clinical data.</p><p><strong>Methods: </strong>This retrospective study included 92 pediatric CD patients (median [IQR] age, 14.6 [12.7, 16.6] years; 65.2% male; 37 responders and 55 non-responders) who underwent MRE within 3 months before initiating anti-TNF therapy between 2009 and 2021. Responders achieved mucosal healing within 36 months; non-responders did not, underwent surgery, or changed therapy. Four pre-treatment feature sets were used: (1) radiologist MRE assessment, (2) radiomic features from bowel regions, (3) deep learning features from representative bowel images, and (4) non-imaging clinical features. A 2-stage stacking ensemble model was trained and evaluated. The area under the receiver operating characteristic curve (AUROC) was the primary performance metric.</p><p><strong>Results: </strong>The multi-modal ensemble model integrating all MRE-based features achieved an AUROC of 0.771 [95% confidence intervals (CI): 0.745, 0.797], outperforming models using individual feature types (radiologist assessment: 0.706 [0.691, 0.721]; radiomic: 0.710 [0.691, 0.729]; deep learning: 0.724 [0.700, 0.749]). Combining MRE and clinical features (0.739 [0.696, 0.781]) achieved the highest AUROC of 0.817 [0.793, 0.842], though not significantly (P = .10). Radiomic features reflecting intensity distribution and texture heterogeneity were most predictive of treatment response.</p><p><strong>Conclusion: </strong>A multi-modal ensemble model combining MRE-based radiologist assessment, radiomic, deep learning, and clinical features accurately predicted anti-TNF treatment response in pediatric CD patients.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1980-1992"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689082","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":"Comparative effectiveness and safety of upadacitinib versus vedolizumab in anti-TNF-exposed patients with ulcerative colitis.","authors":"Jian Wan, Hao Zhang, Xiaojie Yuan, Zhengyu Ren, Sumei Sha, Changyue Wu, Yingchao Li, Xin Liu, Xin Wang, Jiaming Zhou, Chuhan Hu, Fei Chen, Min Chen, Jie Liang, Kaichun Wu","doi":"10.1093/ibd/izag179","DOIUrl":"https://doi.org/10.1093/ibd/izag179","url":null,"abstract":"<p><strong>Background & aims: </strong>Head-to-head comparative evidence between upadacitinib and vedolizumab for anti-tumor necrosis factor (TNF)-exposed ulcerative colitis (UC) patients is lacking. This study compared their real-world effectiveness and safety.</p><p><strong>Methods: </strong>This multicenter retrospective cohort included anti-TNF-exposed UC patients with a partial adapted Mayo score ≥ 2 who received upadacitinib or vedolizumab between March 2021 and February 2026 and had a minimum of 16 weeks of follow-up. Clinical outcomes were assessed at weeks 16 and 26, with endoscopic evaluation at week 26. The primary outcome was steroid-free symptomatic remission (SFSR) at week 16, defined as rectal bleeding subscore = 0 and stool frequency subscore ≤ 1, with no corticosteroid use for at least 2 weeks prior to assessment. Propensity score-based inverse probability of treatment weighting (IPTW) was used to adjust for imbalance of baseline characteristics.</p><p><strong>Results: </strong>A total of 242 patients were analyzed (120 vedolizumab, 122 upadacitinib). After IPTW, upadacitinib was superior in achieving week-16 SFSR (71.7% vs 54.6%; adjusted odds ratio [aOR] 2.11, 95% CI, 1.67-2.65, P < .001). At week 26, upadacitinib remained superior in SFSR (82.6% vs 61.8%; aOR 2.93, 95% CI, 1.85-4.66, P < .001) and also demonstrated higher rates of endoscopic improvement (75.3% vs 47.1%; aOR 3.42, 95% CI, 2.57-4.56, P < .001), and endoscopic remission (41.5% vs 22.2%; aOR 2.49, 95% CI, 1.71-3.63, P < .001). There was no significant difference regarding the risk of drug discontinuation between the two groups (aHR 0.46, 95% CI, 0.20-1.04, P = .058). However, the overall incidence of adverse events was higher with upadacitinib (0.475 vs 0.213 per person-year, P < .001), while the rates of serious adverse events were not significantly different between groups.</p><p><strong>Conclusions: </strong>Upadacitinib demonstrates superior effectiveness over vedolizumab in anti-TNF-exposed UC but carries a higher burden of adverse events, highlighting the need for personalized benefit-risk assessment to guide treatment selection.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109257","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":"Postoperative weight trajectories after ileal pouch-anal anastomosis are associated with the development of Crohn's-like disease of the pouch.","authors":"Stephanie L Gold, Justin Tiao, Michael Plietz, Sue Hahn, Sergey Khaitov, Patricia Sylla, Alexander Greenstein, Marla C Dubinsky, Maia Kayal","doi":"10.1093/ibd/izag183","DOIUrl":"https://doi.org/10.1093/ibd/izag183","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080439","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":"Effectiveness, safety, and clinical outcomes of treatment with the oral α4-integrin antagonist carotegrast methyl in patients with active ulcerative colitis: a multicenter observational study (CANAL study).","authors":"Fumihito Hirai, Katsuyoshi Matsuoka, Kenji Watanabe, Ryota Hokari, Taku Kobayashi, Masayuki Saruta, Hiroshi Nakase, Takayuki Yamamoto, Mao Matsubayashi, Ryuichi Okamoto, Shinichiro Shinzaki, Makoto Naganuma, Hitoshi Hongo, Hirozumi Obata, Katsuya Endo, Akihiro Yamada, Shinya Ashizuka, Noritaka Takatsu, Toshiyuki Sakurai, Tetsuya Ishida, Jun Kato, Masayuki Fukata, Yusuke Takashima, Yoshiyuki Hosoi, Takahiro Suzuki, Gakuto Yamazaki, Toshifumi Hibi, Mamoru Watanabe, Tadakazu Hisamatsu","doi":"10.1093/ibd/izag194","DOIUrl":"https://doi.org/10.1093/ibd/izag194","url":null,"abstract":"<p><strong>Background: </strong>Carotegrast methyl is an oral α4-integrin antagonist used to induce remission in patients with ulcerative colitis with an inadequate response to 5-aminosalicylate (5-ASA). This multicenter, retrospective observational study evaluated the clinical usefulness of carotegrast methyl in real-world practice.</p><p><strong>Methods: </strong>Patients with an inadequate response to 5-ASA who received carotegrast methyl were included. Clinical data were collected during and after treatment for up to 52 weeks. The primary endpoint was the response rate at week 8. The remission rate at week 8, response/remission rate at end of treatment, cumulative response/remission rate, and adverse drug reactions were also assessed. Effectiveness was evaluated using the patient reported outcomes-2 measure (sum of Mayo subscores for stool frequency and rectal bleeding).</p><p><strong>Results: </strong>Data were collected from 196 patients, of whom 180 were evaluable for effectiveness. The PRO-2-defined response and remission rates at week 8 were 57.8% and 43.3%, respectively, and the rates at the end of treatment (median treatment duration: 83.5 days) were 58.9% and 50.0%, respectively. The cumulative PRO-2-defined response/remission rates increased until week 16, followed by a slight further increase. Adverse drug reactions occurred in 31 of 196 patients (15.8%, 43 events), with no serious events.</p><p><strong>Conclusions: </strong>In terms of patient-reported symptom improvement, carotegrast methyl is an effective and well-tolerated treatment for patients with ulcerative colitis who have an inadequate response to 5-ASA. A substantial proportion of patients responded to 8 weeks of treatment. Continued treatment for up to 16 weeks may improve symptoms, even in patients with insufficient response at week 8.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074455","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}