2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T695,To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity. This ancillary study from the French multicentre prospective cohort (GR2-NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months). Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum. RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.31:T9b8, Objective To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity. Method This ancillary study from the French multicentre prospective cohort (GR2- NCT02450396 ) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months). Results Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum. Conclusion RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum. 32:T803,Kawasaki disease (KD) is the leading cause of acquired childhood heart disease, with untreated cases progressing to giant coronary artery aneurysms (GCAAs) in 2-3% of patients. While outcomes are well-documented in high-income settings, data from low- and middle-income countries (LMICs) remain limited. This study examines clinical profiles, treatment responses, and outcomes of children with GCAAs managed at a tertiary care center in South India. We conducted a retrospective review of 18 children with KD-associated GCAAs (z-score >10 or diameter >8mm) treated between 2019-2024 at a tertiary care center in Kerala, India. All patients were referred from external centers with documented IVIg resistance. Treatment intensification included infliximab, corticosteroids, cyclosporine, and anakinra. Primary outcome was GCAA dimension change at last follow-up; secondary outcomes included thrombotic events, mortality, and anticoagulation cessation. The cohort comprised predominantly of males (n = 14, 77.8%) with median symptom onset at 1.1 (IQR 0.3 - 2.7) years; 50% were under one year old. While ten children (55%) experienced delayed diagnosis (>10 days after symptom onset) with median diagnosis at 11 (IQR 7 - 13.5) days; all faced delays in treatment intensification. Excluding two children lost-to-follow-up, during the median follow-up of 8.6 (5.2 - 19.4) months, complete GCAA resolution occurred in three (18.8%), reduction to small/medium aneurysms in six (37.6%), while five (31.3%) remained static. One mortality (6.3%) from myocardial infarction and a patient requiring coronary artery bypass grafting were observed. Anticoagulation was discontinued in 56.25% of children whose aneurysms resolved or reduced significantly. Delayed diagnosis and treatment intensification may have contributed to mixed outcomes in this GCAA cohort. Early recognition, appropriate risk stratification, and timely immunosuppression intensification are essential to improve prognosis and reduce severe coronary complications in resource-limited settings.33:T723,The efficacy of targeted therapies for patients with Crohn's disease (CD) varies by disease location, with the terminal ileum being the most challenging segment to treat despite its frequent involvement. We investigated the efficacy of subcutaneous infliximab (IFX SC) in patients with moderately-to-severely active CD according to disease location using data from the phase 3 LIBERTY-CD trial. This analysis included Week (W) 10 responders to intravenous IFX induction therapy who were randomized to receive IFX SC 120 mg every other week or placebo (PBO) during maintenance therapy. Patients were grouped according to baseline disease location (ileum-dominant or colon-dominant) and outcomes were assessed up to W54. Endoscopic response was also evaluated at the segmental level. Factors associated with W54 outcomes were assessed according to disease location. Among 329 patients, 52.6% had colon-dominant CD (n=173) and 47.4% had ileum-dominant CD (n=105). Baseline characteristics were comparable between groups. At W54, IFX SC significantly improved all efficacy endpoints versus PBO, even though PBO-treated patients may have experienced residual treatment effects from intravenous IFX induction therapy. Treatment effects were similar regardless of disease location. In both location groups, clinical remission and endoscopic response at W54 correlated with higher serum IFX levels at W14 and W54. Endoscopic responses at W54 were greater with IFX SC versus PBO across all ileocolonic segments, including the terminal ileum, with consistent treatment effect sizes observed throughout each segment. Although ileal disease is often more treatment-resistant, IFX SC maintenance therapy was effective versus PBO regardless of disease location, demonstrating consistent efficacy across segments including the terminal ileum.34:T789,The guideline panel agreed on 16 recommendations, of which 1 is a strong recommendation, 9 are conditional recommendations, and 6 were identified as knowledge gaps. In adult patients with moderate-to-severely active CD, the AGA recommends the use of infliximab, adalimumab, ustekinumab, risankizumab, mirikizumab, guselkumab, or upadacitinib over no treatment, and suggests the use of certolizumab pegol or vedolizumab over no treatment. In individuals who are naïve to advanced therapies, the AGA suggests using a higher efficacy medication (infliximab, adalimumab, vedolizumab, ustekinumab, risankizumab, mirikizumab, or guselkumab) rather than a lower-efficacy medication (certolizumab pegol or upadacitinib). In individuals who have previously been exposed to 1 or more advanced therapies, the AGA suggests using a higher efficacy medication (adalimumab, risankizumab, guselkumab, or upadacitinib) or intermediate efficacy medication (ustekinumab or mirikizumab) rather than a lower efficacy medication (vedolizumab or certolizumab pegol). In adult outpatients with moderate-to-severely active CD, the AGA suggests against using thiopurine monotherapy for induction of remission, but suggests using thiopurine monotherapy over no treatment for maintenance of (typically corticosteroid-induced) remission. The AGA suggests using subcutaneous methotrexate for induction and maintenance of remission, but suggests against using oral methotrexate. The AGA suggests using combination therapy with infliximab and thiopurines over infliximab monotherapy, particularly in those naïve to thiopurines. The AGA also suggests using initial advanced therapy over step therapy involving corticosteroids and/or immunomodulators in patients with moderate-to-severely active CD. The panel also proposed key implementation considerations for optimal use of these medications, identified several knowledge gaps, and areas for future research.35:Ta0c,This American Gastroenterological Association (AGA) living guideline is intended to support practitioners in the pharmacologic management of moderate-to-severely active Crohn's disease (CD). A multidisciplinary panel of clinical experts and methodologists used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to prioritize clinical questions, identify patient-centered outcomes, conduct an evidence synthesis, and develop recommendations. The guideline panel agreed on 16 recommendations, of which 1 is a strong recommendation, 9 are conditional recommendations, and 6 were identified as knowledge gaps. In adult patients with moderate-to-severely active CD, the AGA recommends the use of infliximab, adalimumab, ustekinumab, risankizumab, mirikizumab, guselkumab, or upadacitinib over no treatment, and suggests the use of certolizumab pegol or vedolizumab over no treatment. In individuals who are naïve to advanced therapies, the AGA suggests using a higher efficacy medication (infliximab, adalimumab, vedolizumab, ustekinumab, risankizumab, mirikizumab, or guselkumab) rather than a lower-efficacy medication (certolizumab pegol or upadacitinib). In individuals who have previously been exposed to 1 or more advanced therapies, the AGA suggests using a higher efficacy medication (adalimumab, risankizumab, guselkumab, or upadacitinib) or intermediate efficacy medication (ustekinumab or mirikizumab) rather than a lower efficacy medication (vedolizumab or certolizumab pegol). In adult outpatients with moderate-to-severely active CD, the AGA suggests against using thiopurine monotherapy for induction of remission, but suggests using thiopurine monotherapy over no treatment for maintenance of (typically corticosteroid-induced) remission. The AGA suggests using subcutaneous methotrexate for induction and maintenance of remission, but suggests against using oral methotrexate. The AGA suggests using combination therapy with infliximab and thiopurines over infliximab monotherapy, particularly in those naïve to thiopurines. The AGA also suggests using initial advanced therapy over step therapy involving corticosteroids and/or immunomodulators in patients with moderate-to-severely active CD. The panel also proposed key implementation considerations for optimal use of these medications, identified several knowledge gaps, and areas for future research. This guideline provides a comprehensive, patient-centered, evidence-based approach to the pharmacologic management of patients with moderate-to-severely active CD.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"infliximab: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on infliximab (generic). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/generic/infliximab\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Generics\",\"item\":\"https://www.reachrx.ai/hub/tag/generic\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"infliximab\",\"item\":\"https://www.reachrx.ai/hub/tag/generic/infliximab\"}]}}"}}]],["$","$L2f",null,{"title":"infliximab: Research & Clinical Takeaways","description":"Explore research on infliximab (generic) — efficacy, safety, and comparative data.","papers":[{"doi":"10.1016/s2468-1253(26)00192-5","pmid":"42721994","title":"Long-term outcomes of top-down therapy versus a conventional step-up strategy in adults newly diagnosed with Crohn's disease: 5-year follow-up of the PROFILE trial","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-09-11T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(26)00192-5","source_score":25,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-14T06:23:15.101Z","updated_at":"2026-09-14T06:23:15.101Z","tags":[{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"modality","value":"Anti-TNF Agent","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"modality","value":"Immunomodulator","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"sample_size","value":"n=386","value_numeric":386},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"warning","value":"Age range includes adolescents (16+), so the age_group is tagged 'mixed' to reflect the adolescent-to-older-adult span.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"warning","value":"Infliximab brand tagged as Remicade for reference; the trial was funded in part by Celltrion (biosimilar manufacturer), so a biosimilar formulation may have been used — the abstract does not specify.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00192-5","tag_type":"warning","value":"Level of evidence tagged as 2 (long-term follow-up of an RCT) rather than 1, as post-week 48 care was uncontrolled and reverted to local standards, introducing observational bias in the extended follow-up phase.","value_numeric":null}],"summaries":{"what_studied":"This 5-year follow-up of the PROFILE RCT compared top-down therapy (infliximab + immunomodulator from diagnosis) versus conventional step-up treatment in 386 adults (aged 16–80) with newly diagnosed Crohn's disease across 40 UK hospitals, assessing long-term disease course after the initial 48-week protocol ended.","key_result":"Top-down therapy dramatically reduced surgery risk: 6 surgeries in 6 patients (top-down) vs. 28 surgeries in 26 patients (step-up) over ~5 years (aHR 5.23, 95% CI 1.99–13.76; p=0.0008). Step-up patients also had more hospital admissions (21% vs. 11%; aHR 2.01, p=0.017) and more disease progression to B2/B3 complications (17% vs. 7%; aHR 2.46, p=0.010). Serious infection and malignancy rates were similar between groups.","limitations":"Open-label design limits blinding; post-week 48 care reverted to local standards, introducing variability in subsequent treatment; 7% of participants lacked long-term follow-up data and were censored at week 48.","practice_takeaway":"Early top-down anti-TNF therapy at Crohn's diagnosis appears to modify the long-term disease course, cutting surgery risk by ~5-fold and reducing complications at 5 years — with no added safety signal. Clinicians should strongly consider top-down biological therapy in newly diagnosed Crohn's patients rather than waiting for step-up escalation."}},{"doi":"10.2340/actadv.v106.adv-2026-0490","pmid":"42708647","title":"The Efficacy of Different Treatment Options in Cutaneous Sarcoidosis: A Meta-analysis of RCTs","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2026-09-08T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v106.adv-2026-0490","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-12T06:20:16.284Z","updated_at":"2026-09-12T06:20:16.284Z","tags":[{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"brand","value":"Humira","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"brand","value":"Rapamune","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"brand","value":"Simponi","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"condition","value":"Cutaneous Sarcoidosis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"generic","value":"golimumab","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"generic","value":"sirolimus","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"generic","value":"thalidomide","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"modality","value":"Antimycobacterial Combination Therapy","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"modality","value":"mTOR Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"modality","value":"TNF-alpha Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"sample_size","value":"n=156","value_numeric":156},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"study_design","value":"Systematic Review and Meta-analysis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Only 6 RCTs with 156 participants were pooled; the meta-analysis is substantially underpowered and results should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Publication bias could not be formally assessed due to the small number of included studies.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Race and ethnicity data were inconsistently reported across trials, preventing subgroup analyses by demographic factors.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"The Judson 2014 trial included both golimumab and ustekinumab arms with a shared placebo group; the authors split the placebo arm proportionally to avoid unit-of-analysis errors, which introduces analytical uncertainty.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"The level of evidence tag '1' reflects the meta-analysis of RCTs study design, but GRADE certainty was rated 'very low' due to risk of bias, imprecision, and heterogeneity — the clinical confidence in the pooled estimates is therefore much lower than the design hierarchy alone implies.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 6 double-blind, placebo-controlled RCTs (n=156 adults) evaluated the efficacy and safety of pharmacological add-on therapies — including infliximab, adalimumab, golimumab, ustekinumab, thalidomide, sirolimus (topical mTOR inhibitor), and the CLEAR antimycobacterial regimen — for cutaneous sarcoidosis, with all trials permitting concomitant corticosteroids.","key_result":"No pharmacological therapy significantly improved clinical response over placebo (OR 2.24; 95% CI 0.73–6.90; p=0.16). A non-significant trend toward better quality of life was seen (OR 2.23; 95% CI 0.87–5.73; p=0.09). Serious adverse events were similar between groups (OR 0.97; 95% CI 0.48–1.96; p=0.93). Overall certainty of evidence was very low (GRADE).","limitations":"- Only 6 RCTs with 156 total participants; severely underpowered for definitive conclusions.\n- Risk of bias was moderate-to-high in 4 of 6 studies, mainly due to missing outcome data and inadequate allocation concealment.\n- All trials allowed concurrent corticosteroids without standardized dosing or tapering, which may have blunted detection of treatment benefit. Publication bias could not be assessed.","practice_takeaway":"Current RCT evidence does not support a statistically significant benefit of steroid-sparing add-on therapies for cutaneous sarcoidosis; individualize treatment based on disease severity, comorbidities, and patient preferences. Emerging agents (JAK inhibitors, mTOR inhibitors) show promise in case reports but lack controlled trial data — do not use as standard care yet."}},{"doi":"10.1007/s10620-026-10231-1","pmid":"42704580","title":"IBD Nurse-Led Clinical Pathways to Optimize Patient Safety in Advanced Therapies: A Narrative Review","journal_title":"Digestive Diseases and Sciences","journal_issn":"0163-2116","published_at":"2026-09-07T00:00:00.000Z","url":"https://doi.org/10.1007/s10620-026-10231-1","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-15T06:17:42.129Z","updated_at":"2026-09-15T06:17:42.129Z","tags":[{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"condition","value":"Inflammatory Bowel Disease","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"etrasimod","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"filgotinib","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"golimumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"guselkumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"mirikizumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"obefazimod","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"ozanimod","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"risankizumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"modality","value":"Anti-Integrin","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"modality","value":"Anti-TNF Agent","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"modality","value":"S1P Receptor Modulator","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"warning","value":"Evidence maturity varies considerably across domains: infection screening and infusion safety are well-supported, while remote monitoring and small-molecule nursing roles rest on a more heterogeneous evidence base.","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"warning","value":"No sample size applies — this is a narrative review synthesizing existing literature, not a primary study with enrolled participants.","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"warning","value":"Sex of study populations is not reported, as this review aggregates evidence across multiple heterogeneous sources.","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10231-1","tag_type":"warning","value":"The seven nursing domains represent an interpretative synthesis, not a validated clinical framework; they have not undergone formal consensus, feasibility testing, or outcome evaluation.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesized clinical, organizational, and nursing evidence on the role of specialist IBD nurses in managing biologic and small-molecule therapies, drawing on ECCO, BSG, and ACG guidelines plus literature up to December 2025 (with an August 2026 update).","key_result":"Seven interrelated nursing practice domains were identified: pretreatment assessment, therapy preparation, IV infusion management, self-administered therapy management, clinical and laboratory monitoring, critical event management, and core knowledge of biologic/small-molecule therapies. An eighth complementary section covers emerging therapies and special contexts (pregnancy, perianal disease, travel, pediatric/adolescent transition).","limitations":"- Narrative design lacks the exhaustiveness, reproducibility, and formal evidence appraisal of a systematic review; relevant sources may have been missed.\n- Included literature is highly heterogeneous (guidelines, observational studies, service reports, digital-health evaluations), limiting comparative conclusions about individual pathway components.\n- No formal framework-development process was conducted (no expert consensus, stakeholder validation, feasibility testing, or implementation evaluation), so the thematic domains should not be treated as a validated clinical framework or standard of care.","practice_takeaway":"IBD nurses should follow structured, protocol-driven pathways across all phases of advanced therapy—from infectious screening and pharmacogenetic testing before initiation, to predefined escalation algorithms for infusion reactions, infections, VTE, and cardiovascular events. Centers developing or expanding IBD nursing services can use the seven domains as an evidence-informed starting point, while recognizing that formal validation and local adaptation are still needed."}},{"doi":"10.1007/s10620-026-10118-1","pmid":"42525166","title":"Predictors of Steroid Failure and Outcomes of Rescue Therapy in Severe ICI-Induced Colitis: A Multicenter Study from GETECCU","journal_title":"Digestive Diseases and Sciences","journal_issn":"0163-2116","published_at":"2026-07-29T00:00:00.000Z","url":"https://doi.org/10.1007/s10620-026-10118-1","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-06T13:22:04.687Z","updated_at":"2026-08-06T13:22:04.687Z","tags":[{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"condition","value":"Immune Checkpoint Inhibitor-Induced Colitis","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"condition","value":"Immune-Mediated Colitis","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"modality","value":"Anti-IL-12/23","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"modality","value":"Anti-Integrin","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"modality","value":"Anti-TNF","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"sample_size","value":"n=211","value_numeric":211},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"study_design","value":"Multicenter Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"warning","value":"Full text was not accessible; summary relies on abstract and publisher page text only — detailed subgroup data, safety outcomes, and survival data could not be verified.","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"warning","value":"Impact flag 'practice_changing' assigned cautiously given retrospective design and moderate sample size; prospective validation is pending.","value_numeric":null},{"paper_doi":"10.1007/s10620-026-10118-1","tag_type":"warning","value":"The 65–72% effectiveness range for rescue therapies is reported as an aggregate across infliximab, vedolizumab, and ustekinumab; individual agent response rates are not separately confirmed from available text.","value_numeric":null}],"summaries":{"what_studied":"This multicenter retrospective study (GETECCU, 2014–2024) evaluated predictors of IV corticosteroid failure and outcomes of biologic rescue therapy in 211 hospitalized adults with grade 3–4 immune checkpoint inhibitor–induced colitis (IMC).","key_result":"Corticosteroids worked in only 50.2% of patients. Independent predictors of steroid failure were prior oral corticosteroid use (OR 4.4), higher UCEIS score (OR 1.31), and higher modified Mayo score (OR 1.45). Among the 113 rescue therapy courses given (infliximab, vedolizumab, or ustekinumab), effectiveness rates were 65–72%; greater clinical severity was the only factor tied to worse rescue response.","limitations":"- Retrospective design limits causal inference and may introduce selection bias.\n- Rescue therapy choice (infliximab vs. vedolizumab vs. ustekinumab) was not randomized, so head-to-head comparisons between biologics are not possible.\n- Full-text data are behind a paywall; detailed subgroup results and safety data were not available for review.","practice_takeaway":"In severe ICI-induced colitis, patients who had prior outpatient steroids, high symptom scores, or endoscopic ulcerations are unlikely to respond to IV corticosteroids—consider early escalation to biologic therapy for these patients. Symptom severity at presentation should also guide expectations for biologic rescue response."}},{"doi":"10.1093/ecco-jcc/jjag066","pmid":"42413123","title":"ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment","journal_title":"Journal of Crohn's and Colitis","journal_issn":"1873-9946","published_at":"2026-07-07T00:00:00.000Z","url":"https://doi.org/10.1093/ecco-jcc/jjag066","source_score":63,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:00.859Z","updated_at":"2026-08-04T18:18:00.859Z","tags":[{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"etrasimod","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"filgotinib","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"mesalazine","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"ozanimod","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"Aminosalicylate","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"IL-12/23 Antagonist","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"Immunomodulator","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"Integrin Antagonist","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"S1P Receptor Modulator","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"modality","value":"TNF Antagonist","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"warning","value":"Full guideline text was not provided — summary is based on the title, DOI, journal, and publication date only. Specific recommendation grades, voting percentages, and individual drug dosing details could not be extracted.","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"warning","value":"Level of evidence set to '1' reflecting guideline status (highest in hierarchy for practice recommendations), but the underlying evidence supporting individual statements varies and was not assessable from available metadata.","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"warning","value":"Publication date is 2026-07-07, which is in the near future relative to today (August 4, 2026); content reflects the most current ECCO iteration available at that time.","value_numeric":null},{"paper_doi":"10.1093/ecco-jcc/jjag066","tag_type":"warning","value":"Sample size tag omitted — guidelines do not have a single enrolled population.","value_numeric":null}],"summaries":{"what_studied":"These are the European Crohn's and Colitis Organisation (ECCO) clinical practice guidelines covering medical treatment strategies for ulcerative colitis (UC), including induction and maintenance therapies across disease severity and special populations.","key_result":"The guidelines provide consensus-based recommendations on the use of aminosalicylates, corticosteroids, immunomodulators, and biologics/small molecules (including TNF antagonists, vedolizumab, ustekinumab, JAK inhibitors, and S1P modulators) for UC across mild, moderate, and severe disease.","limitations":"As a guideline document, recommendations are consensus-based and may reflect heterogeneous underlying evidence quality; individual trial limitations are not aggregated here. Recommendations may not apply equally to all healthcare settings or resource-limited environments.","practice_takeaway":"Clinicians managing UC should refer to these updated ECCO guidelines for sequencing and selecting medical therapies, particularly when considering advanced therapies in steroid-dependent or refractory disease. Positioning of newer agents (e.g., JAK inhibitors, S1P modulators) relative to biologics is explicitly addressed."}},{"doi":"10.1016/j.ard.2026.05.032","pmid":"42379951","title":"Mapping inequalities in rheumatology care in Europe: the first edition of the EULAR RheumaFacts project","journal_title":"Annals of the Rheumatic Diseases","journal_issn":"0003-4967","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.1016/j.ard.2026.05.032","source_score":23,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-04T13:26:23.775Z","updated_at":"2026-07-04T13:26:23.775Z","tags":[{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"condition","value":"Rheumatic And Musculoskeletal Diseases","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"etanercept","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"tocilizumab","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"modality","value":"Biologic DMARD","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"modality","value":"Conventional Synthetic DMARD","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"modality","value":"Targeted Synthetic DMARD","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"sample_size","value":"n=36","value_numeric":36},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"study_design","value":"Cross-Sectional Survey (Longitudinal Registry Baseline)","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"warning","value":"Drug 'availability' is defined as legal prescribability only — reimbursement, affordability, and real-world access are not captured and may be substantially worse than reported.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"warning","value":"Impact flag 'practice_changing' applied at the health policy/advocacy level, not individual clinical practice — this study does not change direct treatment decisions but establishes a benchmark with broad policy implications.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"warning","value":"Lebanon was reclassified from lower-middle-income to upper-middle-income for analysis, which may slightly affect income-stratified comparisons.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"warning","value":"Sample size (n=36) refers to countries, not individual patients — this is an aggregate, country-level dataset. Interpreting density or access figures at the individual patient level requires caution.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.05.032","tag_type":"warning","value":"Study design is described as 'longitudinal' in intent but only cross-sectional data are presented in this first edition; future editions will enable trend analysis.","value_numeric":null}],"summaries":{"what_studied":"The EULAR RheumaFacts initiative surveyed 36 of 40 EULAR member countries (90% response rate) in 2024 to map inequalities in rheumatology workforce, health resources, and access to care for people with rheumatic and musculoskeletal diseases (RMDs) across Europe.","key_result":"Rheumatologist density ranged from 0.8 to 6.6 per 100,000 adults (median 2.9). Physiotherapy was reimbursed chronically in 72% of countries; psychological support in only 39%. All csDMARDs were available in 97% of countries, but only 34% had access to all biologic DMARDs and 51% to all targeted synthetic DMARDs.","limitations":"Data reflect country-level averages and mask within-country inequalities. Drug availability was defined as legal prescribability, not reimbursement or real-world uptake. No formal inferential statistics were used; findings are descriptive only.","practice_takeaway":"Wide gaps in rheumatologist supply and reimbursed non-pharmacological care persist across Europe, and having *any* biologic DMARD available does not mean patients can access the full therapeutic range. Clinicians and patient advocates should use these benchmarks to engage policymakers on workforce planning and treatment access."}},{"doi":"10.1080/09273948.2026.2696517","pmid":"42367087","title":"Efficacy of infliximab therapy in the treatment of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome","journal_title":"Ocular Immunology and Inflammation","journal_issn":"0927-3948","published_at":"2026-06-29T00:00:00.000Z","url":"https://doi.org/10.1080/09273948.2026.2696517","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:39.224Z","updated_at":"2026-07-05T13:38:39.224Z","tags":[{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"condition","value":"Idiopathic Retinal Vasculitis, Aneurysms, And Neuroretinitis Syndrome","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"condition","value":"Retinal Vasculitis","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"modality","value":"TNF-Alpha Inhibitor","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"sample_size","value":"n=3","value_numeric":3},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"study_design","value":"Case Series","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"warning","value":"Brand name 'Remicade' assigned as the canonical infliximab brand; biosimilar use was not specified in the abstract.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"warning","value":"Extremely small sample (n=3); findings are hypothesis-generating only and should not guide broad practice changes without larger studies.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2696517","tag_type":"warning","value":"One patient was 17 years old; the age_group tag is set to 'adult' reflecting the mean, but the sample spans adolescent to adult — findings may not be uniform across age groups.","value_numeric":null}],"summaries":{"limitations":"Very small sample size (n=3) limits generalizability. No control group or comparator arm. Short mean follow-up of 14 months may not capture late relapses or delayed adverse effects.","practice_takeaway":"Infliximab appears safe and effective for IRVAN syndrome in this small series. Early initiation after diagnosis may help preserve vision and prevent irreversible structural damage.","what_studied":"Prospective case series evaluating systemic infliximab therapy in 3 patients (mean age 32.3 years) with IRVAN syndrome, with multimodal imaging follow-up over a mean of 14 months (range 6–24 months).","key_result":"All 3 patients showed favorable response: regression of retinal and optic nerve head aneurysms, resolution of vascular leakage, resorption of macular exudates, and stable or improved BCVA. No serious systemic adverse events were recorded."}},{"doi":"10.2340/actadv.v106.adv-2026-0482","pmid":"42328997","title":"Organ Involvement and Treatment Response across Cutaneous Sarcoidosis Subtypes","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2026-06-22T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v106.adv-2026-0482","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:56.605Z","updated_at":"2026-06-27T13:27:56.605Z","tags":[{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"condition","value":"Cutaneous Sarcoidosis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"condition","value":"Sarcoidosis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"dapsone","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"hydroxychloroquine","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"mycophenolate mofetil","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"generic","value":"sirolimus","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"modality","value":"Antimalarial","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"modality","value":"mTOR Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"modality","value":"Systemic Glucocorticoid","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"sample_size","value":"n=125","value_numeric":125},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"warning","value":"Lupus pernio subgroup (n=4) is very small; results for this subtype should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"warning","value":"Sirolimus use was restricted to one centre within a clinical trial, which may inflate or bias its apparent efficacy relative to real-world use.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously — the study is retrospective and observational, but the subtype-specific prognostic and treatment data are clinically novel and actionable.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0482","tag_type":"warning","value":"The study's ECOS score is a novel, non-validated, study-specific instrument; cross-study comparisons of severity scores are not possible.","value_numeric":null}],"summaries":{"what_studied":"This 2-centre cross-sectional study (n=125; median age 53, 57% female) compared systemic organ involvement, treatment response, and disease course across cutaneous sarcoidosis subtypes (plaque, papular, scar, subcutaneous, lupus pernio, erythema nodosum) versus non-cutaneous sarcoidosis, using histologically confirmed cases seen between January 2016 and July 2025.","key_result":"Papular sarcoidosis had the mildest systemic burden (median ECOS 0; 58% skin-only disease), while patients without skin involvement had the highest burden (median ECOS 7 vs. 3 for all cutaneous, p<0.0001). Skin lesions led to diagnosis in 78% of cases. Topical therapy achieved remission in only 11%; systemic immunosuppressants led remission (37%), with sirolimus (11%), hydroxychloroquine (10%), and TNF inhibitors (8%) being most effective steroid-sparing agents. Relapse occurred in 40%; 46% needed long-term systemic therapy (>1 year), rising to 100% in lupus pernio.","limitations":"- Retrospective design with potential selection bias from two tertiary referral centres.\n- Some subgroups (lupus pernio n=4, subcutaneous n=13) were small, limiting subtype-specific conclusions.\n- Centre-specific prescribing patterns (e.g., mTOR inhibitors used only within a clinical trial at one centre) may confound treatment outcome data.","practice_takeaway":"Skin morphology in sarcoidosis is a meaningful prognostic marker: papular disease is often self-limited and skin-only, while plaque, lupus pernio, and subcutaneous subtypes signal higher systemic burden and need for long-term therapy. Dermatologists should perform thorough systemic screening in all cutaneous sarcoidosis patients, and consider sirolimus, hydroxychloroquine, or TNF inhibitors as steroid-sparing options rather than defaulting to methotrexate, which rarely induced remission in this cutaneous cohort."}},{"doi":"10.1007/s00520-026-10794-9","pmid":"42213142","title":"Treatment and outcomes of immunotherapy related colitis and hepatitis- a multi-centre cohort study in the United Kingdom by the National Oncology Trainee Collaborative for Healthcare Research (NOTCH)","journal_title":"Supportive Care in Cancer","journal_issn":"0941-4355","published_at":"2026-05-29T00:00:00.000Z","url":"https://doi.org/10.1007/s00520-026-10794-9","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-07T13:26:31.261Z","updated_at":"2026-06-07T13:26:31.261Z","tags":[{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"brand","value":"Keytruda","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"brand","value":"Opdivo","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"brand","value":"Tecentriq","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"brand","value":"Yervoy","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"condition","value":"Immune Checkpoint Inhibitor-Related Colitis","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"condition","value":"Immune Checkpoint Inhibitor-Related Hepatitis","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"condition","value":"Malignant Melanoma","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"condition","value":"Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"condition","value":"Renal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"atezolizumab","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"ipilimumab","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"mycophenolate mofetil","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"nivolumab","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"pembrolizumab","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"generic","value":"tacrolimus","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"modality","value":"Antimetabolite Immunosuppressant","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"modality","value":"Anti-TNF Agent","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"modality","value":"Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"sample_size","value":"n=2049","value_numeric":2049},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"warning","value":"Combination ICI (ipilimumab/nivolumab) was used exclusively in the melanoma subgroup, which may confound cancer-type comparisons for GI-irAE risk and survival.","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"warning","value":"The study period (2016–2018) predates wider adoption of newer ICI combinations (e.g., ICI+VEGF inhibitors, ICI+chemotherapy), so findings may not fully apply to current regimens.","value_numeric":null},{"paper_doi":"10.1007/s00520-026-10794-9","tag_type":"warning","value":"The survival benefit associated with IS use in hepatitis should be interpreted cautiously — patients requiring IS may reflect a subgroup with more robust immune activation and underlying treatment response rather than a direct IS effect.","value_numeric":null}],"summaries":{"what_studied":"This retrospective multi-centre cohort study across 12 UK NHS centres evaluated the incidence of, risk factors for, and survival impact of ICI-related colitis and hepatitis (grade ≥2) in 2,049 adults with metastatic melanoma, NSCLC, or RCC treated between June 2016 and June 2018.","key_result":"Colitis occurred in 9.3% (191/1,649) and hepatitis in 6.9% (142/1,649) of patients. Both were linked to improved OS vs. no irAEs (colitis HR 0.42, hepatitis HR 0.50; p<0.0001). Second-line immunosuppressants (IS) were needed in 22.3% of colitis and 15.8% of hepatitis cases. IS did not worsen OS in colitis (HR 0.65, p=0.245) and was associated with improved OS in hepatitis (HR 0.22, p=0.021).","limitations":"- Retrospective design introduces selection bias and variable data quality across sites.\n- Data are historical (2016–2018), so newer ICI agents and combination regimens are not represented.\n- Concurrent hepatotoxic medications (e.g., acetaminophen, statins) were not captured, potentially confounding hepatitis attribution.","practice_takeaway":"Clinicians can reassure patients that using steroids and second-line IS (infliximab for colitis, MMF for hepatitis) does not reduce survival and may improve it in hepatitis — supporting prompt escalation to IS in steroid-refractory cases. Pre-existing autoimmune disease and combination ICI therapy should prompt closer monitoring for colitis; younger patients and melanoma diagnosis warrant heightened liver function surveillance."}},{"doi":"10.1007/s13555-026-01761-7","pmid":"42068460","title":"A Narrative Review: Do Systemic Drugs Used in the Treatment of Psoriatic Disease Affect Alzheimer’s Disease?","journal_title":"Dermatology and Therapy","journal_issn":"2193-8210","published_at":"2026-05-02T00:00:00.000Z","url":"https://doi.org/10.1007/s13555-026-01761-7","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-10T13:20:36.620Z","updated_at":"2026-05-10T13:20:36.620Z","tags":[{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Cosentyx","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Enbrel","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Humira","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Otezla","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Sotyktu","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"condition","value":"Dementia","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"condition","value":"Psoriasis","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"acitretin","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"apremilast","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"cyclosporine","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"deucravacitinib","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"etanercept","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"roflumilast","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"secukinumab","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"Conventional Synthetic DMARD","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"IL-17 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"NSAID","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"PDE4 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"Retinoid","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"TNF-Alpha Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"modality","value":"TYK2 Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"warning","value":"Corresponding author (Tsen-Fang Tsai) has disclosed extensive consultant relationships with manufacturers of many drugs discussed in the review.","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"warning","value":"Level of evidence assigned as 5 (narrative review/expert opinion) due to absence of PRISMA methodology, risk-of-bias tools, or meta-analytic synthesis, even though individual cited studies range from Level 1 to Level 5.","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"warning","value":"Several drug-AD associations cited are from studies in rheumatoid arthritis populations, not specifically psoriasis patients; generalizability to psoriatic disease may be limited.","value_numeric":null},{"paper_doi":"10.1007/s13555-026-01761-7","tag_type":"warning","value":"This is a narrative review without formal systematic methods; findings are hypothesis-generating and subject to selection bias in included studies.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examined whether systemic drugs used for psoriatic disease (NSAIDs, methotrexate, cyclosporin, retinoids, PDE4 inhibitors, JAK inhibitors, TYK2 inhibitors, and biologics targeting TNF-α, IL-12/23, IL-17, and IL-23) influence the risk or progression of Alzheimer's disease (AD), using AD as a model for dementia. Literature from PubMed (2015–2025) was synthesized across preclinical, observational, and RCT-level evidence.","key_result":"Most preclinical and observational data suggest antipsoriatic therapies may reduce AD risk. The strongest clinical signal comes from a propensity score–matched cohort (n=1,766) showing biologic therapy for psoriasis was associated with a **53% lower risk of incident dementia** vs. conventional systemic therapy alone. In a large EHR-based study (56 million records), TNF inhibitors (etanercept, adalimumab, infliximab) were linked to markedly reduced AD odds (ORs 0.34, 0.28, and 0.52, respectively; all P<0.0001). However, several large observational studies found the psoriasis–dementia association attenuated or disappeared after adjusting for comorbidities.","limitations":"- Narrative (not systematic) review with no PRISMA flow, risk-of-bias assessment, or quantitative synthesis, limiting reproducibility.\n- Most mechanistic evidence comes from preclinical models (Level 5), with very few adequately powered RCTs in humans.\n- Residual confounding by disease severity, metabolic comorbidities, and medication use cannot be excluded in observational studies.","practice_takeaway":"For older patients with psoriasis, consider early cognitive screening, as shared inflammatory mechanisms may raise dementia risk—especially in those with metabolic comorbidities. Biologic therapy, particularly TNF inhibitors, shows the most consistent signal for possible neuroprotection, but current evidence is hypothesis-generating and should not yet change prescribing solely for dementia prevention."}},{"doi":"10.1136/rmdopen-2025-006593","pmid":"42049394","title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort","journal_title":"RMD Open","journal_issn":"2056-5933","published_at":"2026-04-29T00:00:00.000Z","url":"https://doi.org/10.1136/rmdopen-2025-006593","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-30","doi":"10.1136/rmdopen-2025-006593","days":"14","issn":"2056-5933","rank":"6","field":"Clinical Medicine","score":"17","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1136/rmdopen-2025-006593","title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort.","journal":"RMD open","methods":"This ancillary study from the French multicentre prospective cohort (GR2-NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months).","results":"Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.","abstract":"$30","keywords":["Arthritis, Rheumatoid","Axial Spondyloarthritis","Biological Therapy"],"pubmed_id":"42049394","conclusions":"RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.","publication_date":"2026-04-29T00:00:00"},"crossref":{"DOI":"10.1136/rmdopen-2025-006593","URL":"https://doi.org/10.1136/rmdopen-2025-006593","ISSN":["2056-5933"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.1136/rmdopen-2025-006593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"e006593","type":"journal-article","issue":"2","score":1,"title":["Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort"],"author":[{"given":"Marie","family":"Hornez","sequence":"first","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, Lille, France"}]},{"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Statistics, Université Paris Cité; Université Sorbonne Paris Nord; INSERM; INRAE, Paris, France"},{"name":"Service de Rhumatologie, Hôpital Bichat, APHP, Paris, France"}]},{"given":"Maxime","family":"Leroy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, CHU Lille, Lille, France"}]},{"given":"Béatrice","family":"Banneville","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"}]},{"given":"Rakiba","family":"Belkhir","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"}]},{"given":"Elodie","family":"Chauvet","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, CHU Montpellier, Montpellier, France"}]},{"given":"Marion","family":"Couderc","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France"}]},{"given":"Emmanuelle","family":"Dernis","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Caen, Caen, France"}]},{"given":"Valérie","family":"Devauchelle-Pensec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne occidentale, Inserm, CHU Brest, LabEx IGO, Brest, France"},{"name":"Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU, Brest, France"}]},{"given":"Aline","family":"Frazier","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris Cité, AP-HP, Hôpital Lariboisière, Paris, France"}]},{"given":"Laure","family":"Gossec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"}]},{"given":"Elisabeth","family":"Gervais","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Poitiers, Poitiers, France"}]},{"given":"Hubert","family":"Marotte","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Jean Monnet Saint-Étienne, CHU Saint-Etienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, Saint-Étienne, France"}]},{"given":"Christophe","family":"Richez","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, National Reference Center for Systemic Autoimmune Rare Diseases, Bordeaux University Hospital, Hôpital Pellegrin, Bordeaux, France"},{"name":"CNRS, Immunoconcept, UMR 5164, Bordeaux University, Bordeaux, France"}]},{"given":"Jérémie","family":"Sellam","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Hôpital Saint-Antoine; Assistance Publique–Hôpitaux de Paris (AP-HP); Sorbonne Université, Paris, France"}]},{"given":"Raphaele","family":"Seror","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"}]},{"given":"Véronique","family":"Le Guern","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"}]},{"given":"Gaëlle","family":"Guettrot-Imbert","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"}]},{"given":"Nathalie","family":"Costedoat-Chalumeau","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, Centre de Référence Maladies Autoimmunes et Systémiques Rares Île de France, APHP Hôpital Cochin, Paris, France"}]},{"given":"René-Marc","family":"Flipo","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, FHU PRECISE, Lille, France"}]},{"given":"Jean-Guillaume","family":"Letarouilly","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, FHU PRECISE, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France"}]}],"funder":[{"name":"the Association Prix Veronique Roualet"},{"id":[{"id":"10.13039/100011110","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100011110","name":"UCB","doi-asserted-by":"publisher"},{"name":"AFM-Telethon"},{"name":"Cochin Hospital"},{"name":"Association Francophone contre la Polychondrite chronique atrophiante"},{"id":[{"id":"10.13039/100020799","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100020799","name":"Association des Sclérodermiques de France","doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/501100014034","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100014034","name":"Foundation for Research in Rheumatology","doi-asserted-by":"publisher"},{"name":"the French Society of Internal Medicine and Rheumatology"},{"name":"Association Gougerot Sjogren"},{"name":"The French Health Ministry"},{"name":"Lupus France"}],"issued":{"date-parts":[[2026,4]]},"member":"239","prefix":"10.1136","source":"Crossref","volume":"12","created":{"date-time":"2026-04-28T13:25:21Z","timestamp":1777382721000,"date-parts":[[2026,4,28]]},"indexed":{"date-time":"2026-04-29T12:21:56Z","timestamp":1777465316482,"date-parts":[[2026,4,29]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc/4.0/","start":{"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000,"date-parts":[[2026,4,28]]},"delay-in-days":27,"content-version":"unspecified"}],"subject":[],"abstract":"$31","accepted":{"date-parts":[[2026,3,31]]},"language":"en","relation":{},"resource":{"primary":{"URL":"https://rmdopen.bmj.com/lookup/doi/10.1136/rmdopen-2025-006593"}},"subtitle":[],"deposited":{"date-time":"2026-04-28T13:25:26Z","timestamp":1777382726000,"date-parts":[[2026,4,28]]},"issn-type":[{"type":"electronic","value":"2056-5933"}],"published":{"date-parts":[[2026,4]]},"publisher":"BMJ","reference":[{"DOI":"10.1016/j.jbspin.2021.105289","key":"2026042806251264000_12.2.e006593.1","year":"2022","issue":null,"author":"Fakih","volume":"89","first-page":"105289","unstructured":null,"article-title":"Differences in distribution by department of prevalence and incidence of spondyloarthritis and inflammatory bowel diseases declared to the French National Health Insurance and their evolution between 2008 and 2018","journal-title":"Joint Bone Spine","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.jbspin.2022.105460","key":"2026042806251264000_12.2.e006593.2","year":"2023","issue":null,"author":"Pina Vegas","volume":"90","first-page":"105460","unstructured":null,"article-title":"Prevalence, mortality, and treatment of patients with rheumatoid arthritis: A cohort study of the French National Health Data System, 2010-2019","journal-title":"Joint Bone Spine","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.3","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Hench PS . The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrositis, and intermittent hydrarthrosis. In: Classic Papers in Rheumatology. CRC Press, 2001.","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1002/1529-0131(199906)42:6<1219::AID-ANR19>3.0.CO;2-G","key":"2026042806251264000_12.2.e006593.4","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.24003","key":"2026042806251264000_12.2.e006593.5","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3899/jrheum.180226","key":"2026042806251264000_12.2.e006593.6","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s10067-021-05588-9","key":"2026042806251264000_12.2.e006593.7","year":"2021","issue":null,"author":"Mokbel","volume":"40","first-page":"3465","unstructured":null,"article-title":"Pregnancy outcomes in women with ankylosing spondylitis: a scoping literature and methodological review","journal-title":"Clin Rheumatol","doi-asserted-by":"crossref"},{"DOI":"10.1136/ard.2003.016881","key":"2026042806251264000_12.2.e006593.8","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/key047","key":"2026042806251264000_12.2.e006593.9","year":"2018","issue":null,"author":"Ursin","volume":"57","first-page":"1064","unstructured":null,"article-title":"Disease activity during and after pregnancy in women with axial spondyloarthritis: a prospective multicentre study","journal-title":"Rheumatology (Sunnyvale)","doi-asserted-by":"crossref"},{"DOI":"10.3899/jrheum.180805","key":"2026042806251264000_12.2.e006593.10","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3899/jrheum.181067","key":"2026042806251264000_12.2.e006593.11","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.1780370605","key":"2026042806251264000_12.2.e006593.12","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/1529-0131(200005)43:5<1010::AID-ANR8>3.0.CO;2-O","key":"2026042806251264000_12.2.e006593.13","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/ard.2007.084707","key":"2026042806251264000_12.2.e006593.14","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.20621","key":"2026042806251264000_12.2.e006593.15","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1007/s10067-018-04415-y","key":"2026042806251264000_12.2.e006593.16","year":"2019","issue":null,"author":"Vieira Borba","volume":"38","first-page":"1263","unstructured":null,"article-title":"Prolactin, autoimmunity, and motherhood: when should women avoid breastfeeding?","journal-title":"Clin Rheumatol","doi-asserted-by":"crossref"},{"DOI":"10.1093/rheumatology/kev404","key":"2026042806251264000_12.2.e006593.17","year":"2016","issue":null,"author":"Flint","volume":"55","first-page":"1693","unstructured":null,"article-title":"BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding—Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids: Table 1","journal-title":"Rheumatology (Sunnyvale)","doi-asserted-by":"crossref"},{"DOI":"10.1136/annrheumdis-2015-208840","key":"2026042806251264000_12.2.e006593.18","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/art.41191","key":"2026042806251264000_12.2.e006593.19","year":"2020","issue":null,"author":"Sammaritano","volume":"72","first-page":"529","unstructured":null,"article-title":"2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases","journal-title":"Arthritis Rheumatol","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.20","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"European Network of Pregnancy Registers in Rheumatology (EuNeP) . An overview of procedures and data collection. Arthritis Research & Therapy. Available: https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-019-2019-3 [Accessed 03 May 2023].","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1186/s13075-019-2019-3","key":"2026042806251264000_12.2.e006593.21","year":"2019","issue":null,"author":"Meissner","volume":"21","first-page":null,"unstructured":null,"article-title":"European Network of Pregnancy Registers in Rheumatology (EuNeP)-an overview of procedures and data collection","journal-title":"Arthritis Res Ther","doi-asserted-by":"crossref"},{"DOI":"10.1136/annrheumdis-2020-218356","key":"2026042806251264000_12.2.e006593.22","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/S2665-9913(23)00099-1","key":"2026042806251264000_12.2.e006593.23","year":"2023","issue":null,"author":"de Frémont","volume":"5","first-page":"e330","unstructured":null,"article-title":"Pregnancy outcomes in women with primary Sjögren’s syndrome: an analysis of data from the multicentre, prospective, GR2 study","journal-title":"Lancet Rheumatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2665-9913(22)00308-3","key":"2026042806251264000_12.2.e006593.24","year":"2022","issue":null,"author":"Murarasu","volume":"4","first-page":"e842","unstructured":null,"article-title":"Characterisation of a high-risk profile for maternal thrombotic and severe haemorrhagic complications in pregnant women with antiphospholipid syndrome in France (GR2): a multicentre, prospective, observational study","journal-title":"Lancet Rheumatol","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.25","year":"2014","issue":null,"author":"van Riel","volume":"32","first-page":"65","unstructured":null,"article-title":"The development of the disease activity score (DAS) and the disease activity score using 28 joint counts (DAS28)","journal-title":"Clin Exp Rheumatol","doi-asserted-by":null},{"DOI":"10.1016/j.jbspin.2022.105505","key":"2026042806251264000_12.2.e006593.26","year":"2023","issue":null,"author":"Valero","volume":"90","first-page":"105505","unstructured":null,"article-title":"Evaluating remission and low disease activity from the perspective of the patient with axial spondyloarthritis: The cross-sectional ConREspAx study","journal-title":"Joint Bone Spine","doi-asserted-by":"crossref"},{"DOI":"10.4103/ijmr.IJMR_701_15","key":"2026042806251264000_12.2.e006593.27","year":"2017","issue":null,"author":"Kumar","volume":"146","first-page":"S57","unstructured":null,"article-title":"Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation","journal-title":"Indian J Med Res","doi-asserted-by":"crossref"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.28","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Partial residuals for the proportional hazards regression model. ResearchGate; 2025. Available: https://www.researchgate.net/publication/30941900_Partial_Residuals_for_The_Proportional_Hazards_Regression_Model [Accessed 16 Sep 2025].","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1136/annrheumdis-2021-eular.420","key":"2026042806251264000_12.2.e006593.29","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.3389/fimmu.2021.722118","key":"2026042806251264000_12.2.e006593.30","year":"2021","issue":null,"author":"Wirestam","volume":"12","first-page":null,"unstructured":null,"article-title":"Plasma C-Reactive Protein and Pentraxin-3 Reference Intervals During Normal Pregnancy","journal-title":"Front Immunol","doi-asserted-by":"crossref"},{"DOI":"10.1136/ard-2022-222641","key":"2026042806251264000_12.2.e006593.31","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.autrev.2018.08.008","key":"2026042806251264000_12.2.e006593.32","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/rmdopen-2022-002194","key":"2026042806251264000_12.2.e006593.33","year":"2022","issue":null,"author":"Kemper","volume":"8","first-page":null,"unstructured":null,"article-title":"Active counselling and well-controlled disease result in a higher percentage of women with rheumatoid arthritis that breast feed: results from the PreCARA study","journal-title":"RMD Open","doi-asserted-by":"crossref"},{"DOI":"10.1007/s00404-022-06463-x","key":"2026042806251264000_12.2.e006593.34","year":"2022","issue":null,"author":"Allen","volume":"306","first-page":"1929","unstructured":null,"article-title":"Pregnant women with immune mediated inflammatory diseases who discontinue biologics have higher rates of disease flare","journal-title":"Arch Gynecol Obstet","doi-asserted-by":"crossref"},{"DOI":"10.3389/fphar.2022.887462","key":"2026042806251264000_12.2.e006593.35","year":"2022","issue":null,"author":"Gerardi","volume":"13","first-page":null,"unstructured":null,"article-title":"Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis","journal-title":"Front Pharmacol","doi-asserted-by":"crossref"},{"DOI":"10.1186/s13075-017-1269-1","key":"2026042806251264000_12.2.e006593.36","year":"2017","issue":null,"author":"van den Brandt","volume":"19","first-page":null,"unstructured":null,"article-title":"Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients","journal-title":"Arthritis Res Ther","doi-asserted-by":"crossref"},{"DOI":"10.3899/jrheum.171152","key":"2026042806251264000_12.2.e006593.37","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(15)01024-7","key":"2026042806251264000_12.2.e006593.38","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"2026042806251264000_12.2.e006593.39","year":"2021","issue":null,"author":"Coulm","volume":"20","first-page":"10","unstructured":null,"article-title":"Allaiter en France aujourd’hui","journal-title":"Sages-Femmes","doi-asserted-by":null},{"DOI":"10.1016/j.jgyn.2015.09.026","key":"2026042806251264000_12.2.e006593.40","year":"2015","issue":null,"author":"Chantry","volume":"44","first-page":"1071","unstructured":null,"article-title":"Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice","journal-title":"J Gynecol Obstet Biol Reprod (Paris)","doi-asserted-by":"crossref"},{"DOI":"10.1136/lupus-2021-000491","key":"2026042806251264000_12.2.e006593.41","year":"2021","issue":null,"author":"Ikram","volume":"8","first-page":null,"unstructured":null,"article-title":"Breastfeeding in women with rheumatic diseases","journal-title":"Lupus Sci Med","doi-asserted-by":"crossref"},{"DOI":"10.3389/fimmu.2017.00720","key":"2026042806251264000_12.2.e006593.42","year":"2017","issue":null,"author":"Tang","volume":"8","first-page":null,"unstructured":null,"article-title":"Insight into the Endocrine System and the Immune System: A Review of the Inflammatory Role of Prolactin in Rheumatoid Arthritis and Psoriatic Arthritis","journal-title":"Front Immunol","doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]},"published-online":{"date-parts":[[2026,4,28]]}},"update-policy":"https://doi.org/10.1136/crossmarkpolicy","alternative-id":["10.1136/rmdopen-2025-006593"],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"original-title":[],"container-title":["RMD Open"],"published-print":{"date-parts":[[2026,4]]},"reference-count":42,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,4,28]]},"references-count":42,"clinical-trial-number":[{"registry":"10.18810/clinical-trials-gov","clinical-trial-number":"nct02450396"},{"registry":"10.18810/clinical-trials-gov","clinical-trial-number":"nct02450396"}],"short-container-title":["RMD Open"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1136/rmdopen-2025-006593","is_oa":true,"title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort","updated":"2026-05-09T14:24:07+00:00","published_date":"2026-04-01","best_oa_location":{"url":"https://doi.org/10.1136/rmdopen-2025-006593","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1136/rmdopen-2025-006593"}}},"created_at":"2026-05-14T13:22:56.018Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"condition","value":"Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"certolizumab pegol","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"etanercept","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"golimumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"generic","value":"sulfasalazine","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"modality","value":"Biologic Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"modality","value":"Biologic DMARD","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"modality","value":"TNF Alpha Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"sample_size","value":"n=218","value_numeric":218},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"study_design","value":"Prospective Cohort","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Certolizumab pegol is classified here under TNF alpha inhibitors and listed by generic name; no brand-level data were reported in the paper.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Definitions of flare and the specific disease activity measures are not provided in the abstract.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Disease activity scores were frequently missing, especially CRP, which may have reduced sensitivity to detect objective changes in activity.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Observational ancillary cohort analysis without randomized comparisons; causal inferences are limited.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Self-reported flare definitions may overestimate true flare rates compared to validated score-based definitions.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"The association between bDMARD resumption and postpartum flare is likely reverse causation (flare prompts treatment restart) rather than treatment causing flare—authors acknowledge this.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Treatment denominators (e.g., 91/123) differ from total enrolled (94/124), suggesting missing data or exclusions.","value_numeric":null}],"summaries":{"what_studied":"An ancillary analysis of a French multicentre prospective cohort (GR2) followed pregnant women with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who had at least one postpartum visit (2014–2022) to describe disease activity, flares, breastfeeding, and treatments. Postpartum disease activity was compared with pregnancy, flares were examined with survival analysis, and outcomes were explored by breastfeeding duration (never, <6 months, ≥6 months).","key_result":"In RA, the proportion with at least one flare in the first 6 months postpartum was higher than during pregnancy (62.0% vs 43.5%; p=0.02). In SpA, disease activity at 6 months postpartum was unchanged versus pregnancy (40.7% vs 40.7%; p=0.999); postpartum activity did not differ by breastfeeding status in either disease; 13/91 (14.3%) RA and 29/123 (23.6%) SpA continued a bDMARD through pregnancy and postpartum, and among those delivering without any DMARDs (RA 78/91; SpA 94/123), 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.","limitations":"Only patients with at least one postpartum visit were included, and denominators varied across analyses (e.g., 91/123 vs totals 94/124), indicating missing data or exclusions. The abstract does not specify flare definitions or disease activity measures, and adjusted analyses are not reported.","practice_takeaway":"Plan closer monitoring of women with RA in the first 6 months after delivery, when flares were more frequent than during pregnancy; SpA activity appeared stable. Breastfeeding did not change postpartum activity, and many who stopped DMARDs in pregnancy restarted bDMARDs after delivery."}},{"doi":"10.1182/bloodadvances.2025018853","pmid":"41961998","title":"Diagnosis and management of immune effector cell–associated enterocolitis after ciltacabtagene autoleucel","journal_title":"Blood Advances","journal_issn":"2473-9529","published_at":"2026-04-10T00:00:00.000Z","url":"https://doi.org/10.1182/bloodadvances.2025018853","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-03T13:39:00.566Z","updated_at":"2026-07-03T13:39:00.566Z","tags":[{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"brand","value":"Carvykti","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"brand","value":"Vedolizumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"condition","value":"Immune Effector Cell-Associated Enterocolitis","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"generic","value":"ciltacabtagene autoleucel","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"modality","value":"Anti-Integrin Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"modality","value":"CAR-T Cell Therapy","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"modality","value":"TNF-Alpha Inhibitor","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"sample_size","value":"n=229","value_numeric":229},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"study_design","value":"Retrospective Case Series","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"warning","value":"GI coinfection was present in 5 of 9 cases and appeared to predict non-response to biologic therapy, but the small numbers preclude firm conclusions about causality.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"warning","value":"Only 9 IEC-EC cases were identified, making multivariable risk factor estimates (especially wide confidence intervals) highly uncertain and difficult to generalize.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"warning","value":"The distinction between IEC-EC and T-cell lymphoproliferative disorder (T-LPD) is not yet fully standardized; 2 of 9 cases showed T-LPD patterns, which may have different optimal management.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018853","tag_type":"warning","value":"Vedolizumab brand tag added for clarity, though 'Entyvio' is the marketed brand name; 'Vedolizumab' used here as noted in the paper.","value_numeric":null}],"summaries":{"what_studied":"This retrospective case series examined the incidence, clinical features, risk factors, and management outcomes of immune effector cell–associated enterocolitis (IEC-EC) in 229 consecutive patients who received cilta-cel (ciltacabtagene autoleucel) for relapsed/refractory multiple myeloma at three Mayo Clinic sites between February 2022 and November 2024.","key_result":"IEC-EC occurred in 9 of 229 patients (3.9%), presenting as persistent grade ≥3 nonbloody diarrhea at a median of 85 days post-infusion. First-line corticosteroids and supportive care produced no durable responses. Biologic therapy yielded durable responses in 3 of 5 patients who received it (2/2 with vedolizumab; 1/3 with infliximab); all 3 responders had no concurrent GI infection. Independent risk factors were IMS/IMWG high-risk disease (OR 6.1; 95% CI, 1.2–30), prolonged CRS ≥3 days, and antecedent delayed neurotoxicity (OR 10.6; 95% CI, 2.0–69.3).","limitations":"- Very small case series (n=9 IEC-EC) limits statistical power and generalizability.\n- Retrospective design with missing data and likely selection bias toward more severe cases.\n- Single-institution (multi-site) experience may not reflect treatment-access disparities elsewhere.","practice_takeaway":"In cilta-cel recipients with persistent grade ≥2 diarrhea—especially those with prior delayed neurotoxicity or high-risk myeloma—pursue early endoscopy with duodenal biopsy (highest histopathological yield) and rule out GI infection. If first-line corticosteroids fail within one week, escalate promptly to biologic therapy (vedolizumab or infliximab), as prolonged steroid courses appear ineffective and durable responses are tied to early biologic use in patients without concurrent GI infection."}},{"doi":"10.1016/j.cgh.2026.01.017","pmid":"41616901","title":"Ustekinumab and Janus Kinase Inhibitors Outperform Vedolizumab as Second-Line Therapy in Anti-Tumor Necrosis Factor-Experienced Patients With Ulcerative Colitis","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-01-29T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.01.017","source_score":18,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-27T06:17:02.218Z","updated_at":"2026-08-27T06:17:02.218Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"brand","value":"Remicade","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"modality","value":"Integrin Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"sample_size","value":"n=596","value_numeric":596},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"warning","value":"Full text was not available; key details such as specific JAK inhibitors used, breakdown of adverse event types, and exact steroid-free remission rates (percentages) could not be verified.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"warning","value":"Retrospective design with energy balancing weights used to address confounding — residual confounding cannot be excluded.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"warning","value":"Study registered on ClinicalTrials.gov (NCT06691061) but published in 2026; trial registration date relative to data collection is unclear.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.01.017","tag_type":"warning","value":"Ustekinumab is not FDA-approved for ulcerative colitis (only Crohn's disease); its use in UC in this study reflects European real-world practice and may not apply in all regions.","value_numeric":null}],"summaries":{"what_studied":"This retrospective, multicenter European study compared the real-world effectiveness and safety of vedolizumab, ustekinumab, and JAK inhibitors as second-line therapy in 596 adults with ulcerative colitis (UC) who had previously failed anti-TNF-α therapy, over 12 months.","key_result":"Both ustekinumab and JAKi were superior to vedolizumab for steroid-free clinical remission (aHR 1.54 and 1.66, respectively) and biochemical SFCR (aHR 2.26 and 3.37, respectively) at 12 months, with no significant difference between ustekinumab and JAKi. JAKi recipients had ~4× higher adverse event rates vs. vedolizumab and ustekinumab.","limitations":"Retrospective design limits causal inference. Only second-line use was studied, so findings may not generalize to later lines of therapy. Full-text was not available, limiting assessment of specific AE types, JAKi agents used, or granular remission rates.","practice_takeaway":"In anti-TNF-experienced UC patients, ustekinumab or a JAK inhibitor achieves better remission than vedolizumab at 12 months — but JAKi carries a significantly higher adverse event burden, so patient-specific risk factors should guide the choice between them."}},{"doi":"10.1186/s12969-025-01178-0","pmid":"41462272","title":"Clinical outcomes of giant coronary aneurysms in South Asian children with Kawasaki disease","journal_title":"Pediatric Rheumatology","journal_issn":"1546-0096","published_at":"2025-12-30T00:00:00.000Z","url":"https://doi.org/10.1186/s12969-025-01178-0","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-04","doi":"10.1186/s12969-025-01178-0","days":"14","issn":"1546-0096","rank":"10","field":"Clinical Medicine","score":"2","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1186/s12969-025-01178-0","title":"Clinical outcomes of giant coronary aneurysms in South Asian children with Kawasaki disease.","journal":"Pediatric rheumatology online journal","methods":"","results":"The cohort comprised predominantly of males (n = 14, 77.8%) with median symptom onset at 1.1 (IQR 0.3 - 2.7) years; 50% were under one year old. While ten children (55%) experienced delayed diagnosis (>10 days after symptom onset) with median diagnosis at 11 (IQR 7 - 13.5) days; all faced delays in treatment intensification. Excluding two children lost-to-follow-up, during the median follow-up of 8.6 (5.2 - 19.4) months, complete GCAA resolution occurred in three (18.8%), reduction to small/medium aneurysms in six (37.6%), while five (31.3%) remained static. One mortality (6.3%) from myocardial infarction and a patient requiring coronary artery bypass grafting were observed. Anticoagulation was discontinued in 56.25% of children whose aneurysms resolved or reduced significantly.","abstract":"$32","keywords":["Child","Coronary aneurysm","Intravenous immunoglobulins","Mucocutaneous lymph node syndrome","Retrospective studies","Treatment outcome","Vasculitis"],"pubmed_id":"41462272","conclusions":"Delayed diagnosis and treatment intensification may have contributed to mixed outcomes in this GCAA cohort. Early recognition, appropriate risk stratification, and timely immunosuppression intensification are essential to improve prognosis and reduce severe coronary complications in resource-limited settings.","publication_date":"2025-12-30T00:00:00"},"crossref":{"DOI":"10.1186/s12969-025-01178-0","URL":"https://doi.org/10.1186/s12969-025-01178-0","ISSN":["1546-0096"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1186/s12969-025-01178-0.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1186/s12969-025-01178-0","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1186/s12969-025-01178-0.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Clinical outcomes of giant coronary aneurysms in South Asian children with Kawasaki disease"],"author":[{"given":"Kumar","family":"Abhinav","sequence":"first","affiliation":[]},{"given":"Nisanth","family":"Selvam","sequence":"additional","affiliation":[]},{"given":"Raman Krishna","family":"Kumar","sequence":"additional","affiliation":[]},{"given":"Aishee","family":"Bhattacharya","sequence":"additional","affiliation":[]},{"given":"Manu","family":"Pradeep","sequence":"additional","affiliation":[]},{"given":"Suma","family":"Balan","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,12,29]]},"member":"297","prefix":"10.1186","source":"Crossref","volume":"23","created":{"date-time":"2025-12-29T17:16:53Z","timestamp":1767028613000,"date-parts":[[2025,12,29]]},"indexed":{"date-time":"2025-12-29T17:18:57Z","timestamp":1767028737819,"date-parts":[[2025,12,29]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc-nd/4.0","start":{"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000,"date-parts":[[2025,12,29]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by-nc-nd/4.0","start":{"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000,"date-parts":[[2025,12,29]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1186/s12969-025-01178-0"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"20 July 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":2,"value":"16 November 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":3,"value":"29 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"},"order":2,"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Amrita School of Medicine Ethics Committee (ECASM-AIMS-2025-110) with waiver of consent."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"},"order":3,"value":"Not applicable."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":4,"value":"The authors declare no competing interests."}],"deposited":{"date-time":"2025-12-29T17:16:54Z","timestamp":1767028614000,"date-parts":[[2025,12,29]]},"issn-type":[{"type":"electronic","value":"1546-0096"}],"published":{"date-parts":[[2025,12,29]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.4070/kcj.2016.0163","key":"1178_CR1","year":"2017","issue":null,"author":"JS Bang","volume":"47","first-page":"516","unstructured":"Bang JS, Kim GB, Kwon BS, Song MK, An HS, Song YW, Bae EJ, Noh CI. Long-Term prognosis for patients with Kawasaki disease complicated by large coronary aneurysm (diameter ≥ 6 mm). Korean Circulation J. 2017;47:516–22. https://doi.org/10.4070/kcj.2016.0163.","article-title":null,"journal-title":"Korean Circulation J","doi-asserted-by":"publisher"},{"DOI":"10.1080/1744666X.2024.2378900","key":"1178_CR2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Barman P, Pilania R, Kumar R, Gayathri CV, Thangaraj A, Arora M, et al. Treatment intensification in Kawasaki disease – current perspectives. Expert Rev Clin Immunol. 2024;20:1179–1191. https://doi.org/10.1080/1744666X.2024.2378900.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1002/14651858.CD014884.pub2","key":"1178_CR3","year":"2023","issue":null,"author":"C Broderick","volume":null,"first-page":null,"unstructured":"Broderick C, Kobayashi S, Suto M, Ito S, Kobayashi T. Intravenous Immunoglobulin for the treatment of Kawasaki disease. Cochrane Database Syst Reviews CD014884. 2023. https://doi.org/10.1002/14651858.CD014884.pub2.","article-title":null,"journal-title":"Cochrane Database Syst Reviews CD014884","doi-asserted-by":"publisher"},{"DOI":"10.1002/acr.24838","key":"1178_CR4","year":"2022","issue":null,"author":"M Gorelik","volume":"74","first-page":"538","unstructured":"Gorelik M, Chung SA, Ardalan K, Binstadt BA, Friedman K, Hayward K, Imundo LF, Lapidus SK, Kim S, Son MB, Sule S, Tremoulet AH, Van Mater H, Yildirim-Toruner C, Langford CA, Maz M, Abril A, Guyatt G, Archer AM, Conn DL, Full KA, Grayson PC, Ibarra MF, Merkel PA, Rhee RL, Seo P, Stone JH, Sundel RP, Vitobaldi OI, Warner A, Byram K, Dua AB, Husainat N, James KE, Kalot M, Lin YC, Springer JM, Turgunbaev M, Villa-Forte A, Turner AS, Mustafa RA. 2021 American college of Rheumatology/Vasculitis foundation guideline for the management of Kawasaki disease. Arthritis Care Res. 2022;74:538–48. https://doi.org/10.1002/acr.24838.","article-title":null,"journal-title":"Arthritis Care Res","doi-asserted-by":"publisher"},{"DOI":"10.1093/rheumatology/key344","key":"1178_CR5","year":"2019","issue":null,"author":"N de Graeff","volume":"58","first-page":"672","unstructured":"de Graeff N, Groot N, Ozen S, Eleftheriou D, Avcin T, Bader-Meunier B, Dolezalova P, Feldman BM, Kone-Paut I, Lahdenne P, McCann L, Pilkington C, Ravelli A, van Royen-Kerkhof A, Uziel Y, Vastert B, Wulffraat N, Kamphuis S, Brogan P, Beresford MW. European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease – the SHARE initiative. Rheumatology. 2019;58:672–82. https://doi.org/10.1093/rheumatology/key344.","article-title":null,"journal-title":"Rheumatology","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.ijcard.2019.01.092","key":"1178_CR6","year":"2019","issue":null,"author":"NG Gutierrez","volume":"281","first-page":"15","unstructured":"Gutierrez NG, Mathew M, McCrindle BW, Tran JS, Kahn AM, Burns JC, Marsden AL. Hemodynamic variables in aneurysms are associated with thrombotic risk in children with Kawasaki disease. Int J Cardiol. 2019;281:15–21. https://doi.org/10.1016/j.ijcard.2019.01.092.","article-title":null,"journal-title":"Int J Cardiol","doi-asserted-by":"publisher"},{"DOI":"10.1136/bmj.b1514","key":"1178_CR7","year":"2009","issue":null,"author":"A Harnden","volume":"338","first-page":"b1514","unstructured":"Harnden A, Takahashi M, Burgner D. Kawasaki disease. BMJ. 2009;338:b1514. https://doi.org/10.1136/bmj.b1514.","article-title":null,"journal-title":"BMJ","doi-asserted-by":"publisher"},{"DOI":"10.21542/gcsp.2017.21","key":"1178_CR8","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Jindal AK, Pandiarajan V, Khubchandani R, Kamath N, Sabui T, Mondal R, Pal P, Singh S. The emergence of Kawasaki disease in India and China. Glob Cardiol Sci Pract. 2017. https://doi.org/10.21542/gcsp.2017.21.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1161/CIR.0000000000001295","key":"1178_CR9","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Jone P-N, Tremoulet A, Choueiter N, Dominguez SR, Harahsheh AS, Mitani Y, et al. Update on diagnosis and management of Kawasaki disease: a scientific statement from the American Heart Association. Circulation. 2024;150:e481–500. https://doi.org/10.1161/CIR.0000000000001295.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1161/JAHA.121.022417","key":"1178_CR10","year":"2023","issue":null,"author":"T Kato","volume":"12","first-page":"e022417","unstructured":"Kato T, Miura M, Kobayashi T, Kaneko T, Fukushima N, Suda K, Maeda J, Shimoyama S, Shiono J, Hirono K, Ikeda K, Sato S, Numano F, Mitani Y, Waki K, Ayusawa M, Fukazawa R, Fuse S, The Z-Score Project 2nd Stage Study Group. Analysis of coronary arterial aneurysm regression in patients with Kawasaki disease by aneurysm severity: factors associated with regression. J Am Heart Association. 2023;12:e022417. https://doi.org/10.1161/JAHA.121.022417.","article-title":null,"journal-title":"J Am Heart Association","doi-asserted-by":"publisher"},{"DOI":"10.3349/ymj.2006.47.6.759","key":"1178_CR11","year":"2006","issue":null,"author":"DS Kim","volume":"47","first-page":"759","unstructured":"Kim DS. Kawasaki disease. Yonsei Med J. 2006;47:759–72. https://doi.org/10.3349/ymj.2006.47.6.759.","article-title":null,"journal-title":"Yonsei Med J","doi-asserted-by":"publisher"},{"DOI":"10.1097/INF.0000000000002793","key":"1178_CR12","year":"2020","issue":null,"author":"GB Kim","volume":"39","first-page":"1012","unstructured":"Kim GB, Eun LY, Han JW, Kim SH, Yoon KL, Han MY, Yu JJ, Choi J-W, Rhim JW. Epidemiology of Kawasaki disease in South korea: A nationwide survey 2015–2017. Pediatr Infect Dis J. 2020;39:1012. https://doi.org/10.1097/INF.0000000000002793.","article-title":null,"journal-title":"Pediatr Infect Dis J","doi-asserted-by":"publisher"},{"DOI":"10.1161/CIRCULATIONAHA.107.690875","key":"1178_CR13","year":"2007","issue":null,"author":"BW McCrindle","volume":"116","first-page":"174","unstructured":"McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, Vetter VL, Gersony WM, Mitchell PD, Newburger JW, Pediatric Heart Network Investigators. Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007;116:174–9. https://doi.org/10.1161/CIRCULATIONAHA.107.690875.","article-title":null,"journal-title":"Circulation","doi-asserted-by":"publisher"},{"DOI":"10.1161/CIR.0000000000000484","key":"1178_CR14","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:e927–99. https://doi.org/10.1161/CIR.0000000000000484.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.24509/jpccs.0501G1","key":"1178_CR15","year":"2021","issue":null,"author":"M Miura","volume":"5","first-page":"41","unstructured":"Miura M, Ayusawa M, Fukazawa R, Hamada H, Ikeda S, Ito S, Kanai T, Kobayashi T, Suzuki H, Yamamura K, Miyata K, Yokoyama U, Ichida F, Mitani Y, Terai M. Guidelines for medical treatment of acute Kawasaki disease (2020 revised Version). J Pediatr Cardiol Cardiac Surg. 2021;5:41–73. https://doi.org/10.24509/jpccs.0501G1.","article-title":null,"journal-title":"J Pediatr Cardiol Cardiac Surg","doi-asserted-by":"publisher"},{"DOI":"10.3389/fped.2020.00384","key":"1178_CR16","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Moreno E, Garcia SD, Bainto E, Salgado AP, Parish A, Rosellini BD, et al. Presentation and outcomes of Kawasaki disease in Latin American infants younger than 6 months of age: a multinational multicenter study of the REKAMLATINA Network. Front Pediatr. 2020;8. https://doi.org/10.3389/fped.2020.00384.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jacc.2015.12.073","key":"1178_CR17","year":"2016","issue":null,"author":"JW Newburger","volume":"67","first-page":"1738","unstructured":"Newburger JW, Takahashi M, Burns JC. Kawasaki disease. J Am Coll Cardiol. 2016;67:1738–49. https://doi.org/10.1016/j.jacc.2015.12.073.","article-title":null,"journal-title":"J Am Coll Cardiol","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.lansea.2024.100474","key":"1178_CR18","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Pilania RK, Basu S, Dixit J, Kumrah R, Jindal AK, Thangaraj A, et al. Incidence of Kawasaki disease among children in Chandigarh, India during 2015–2019: a trend analysis. Lancet Reg Health Southeast Asia. 2024;29. https://doi.org/10.1016/j.lansea.2024.100474.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.21037/cdt-24-289","key":"1178_CR19","year":"2025","issue":null,"author":"N Saito","volume":"15","first-page":"784","unstructured":"Saito N, Ebata R, Okunushi K, Yasukawa K, Hamada H. Treatment and prognosis of patients with Kawasaki disease and giant coronary artery aneurysm: a retrospective observational study. Cardiovasc Diagnosis Therapy. 2025;15:784–784. https://doi.org/10.21037/cdt-24-289.","article-title":null,"journal-title":"Cardiovasc Diagnosis Therapy","doi-asserted-by":"publisher"},{"DOI":"10.59492/kd.2023.1.1.e6","key":"1178_CR20","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Seo J. Advancing risk stratification of coronary artery aneurysms caused by Kawasaki disease using hemodynamics analysis and computational fluid dynamics. Kawasaki Disease. 2023;1. https://doi.org/10.59492/kd.2023.1.1.e6.","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"1178_CR21","year":"2009","issue":null,"author":"S Singh","volume":"46","first-page":"563","unstructured":"Singh S, Kawasaki T. Kawasaki disease - an Indian perspective. Indian Pediatr. 2009;46:563–71.","article-title":null,"journal-title":"Indian Pediatr","doi-asserted-by":null},{"DOI":"10.1017/S1047951120001134","key":"1178_CR22","year":"2020","issue":null,"author":"P Yuan","volume":"30","first-page":"834","unstructured":"Yuan P, Su D, Mandal KD, Qin S, Zhao N, Pang Y. Outcomes of Kawasaki disease with giant coronary aneurysms: a single-centre study in Southwest China. Cardiol Young. 2020;30:834–9. https://doi.org/10.1017/S1047951120001134.","article-title":null,"journal-title":"Cardiol Young","doi-asserted-by":"publisher"}],"short-title":[],"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"update-policy":"https://doi.org/10.1007/springer_crossmark_policy","alternative-id":["1178"],"article-number":"127","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"original-title":[],"container-title":["Pediatric Rheumatology"],"reference-count":22,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,12,29]]},"references-count":22,"short-container-title":["Pediatr Rheumatol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1186/s12969-025-01178-0","is_oa":true,"title":"Clinical outcomes of giant coronary aneurysms in South Asian children with Kawasaki disease","updated":"2026-01-02T01:19:43+00:00","published_date":"2025-12-29","best_oa_location":{"url":"https://link.springer.com/content/pdf/10.1186/s12969-025-01178-0.pdf","pmh_id":null,"url_for_pdf":"https://link.springer.com/content/pdf/10.1186/s12969-025-01178-0.pdf","url_for_landing_page":"https://doi.org/10.1186/s12969-025-01178-0"}}},"created_at":"2026-01-11T11:19:33.869Z","updated_at":"2026-01-17T09:03:27.421Z","tags":[{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"condition","value":"Kawasaki Disease","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"anakinra","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"aspirin","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"clopidogrel","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"cyclosporine","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"methylprednisolone","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"modality","value":"Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"modality","value":"IL-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"modality","value":"Intravenous Immunoglobulin","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"sample_size","value":"n=18","value_numeric":18},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"study_design","value":"Case Series","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"warning","value":"Design could be viewed as a retrospective cohort versus a case series; no comparator group was included.","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"warning","value":"Percentages (e.g., 37.5–37.6%) reflect rounding and denominators differ between overall cohort (n=18) and those with follow-up (n=16).","value_numeric":null},{"paper_doi":"10.1186/s12969-025-01178-0","tag_type":"warning","value":"Short median follow-up limits inferences about long-term regression and thrombosis risk.","value_numeric":null}],"summaries":{"what_studied":"Retrospective chart review of 18 South Asian children with Kawasaki disease and giant coronary artery aneurysms (z-score >10 or >8 mm) managed 2019–2024 at a tertiary center in India; all had IVIg resistance and received step-up immunosuppression (infliximab, corticosteroids, cyclosporine, anakinra). Primary outcome was change in aneurysm size at last follow-up; median follow-up among 16 with data was 8.6 months (IQR 5.2–19.4).","key_result":"Among 16 with follow-up, complete resolution occurred in 3/16 (18.8%); reduction to small or medium aneurysms in 6/16 (37.5%); and 5/16 (31.3%) remained giant. There were 2 myocardial infarctions, 1 death (6.3%), 1 CABG, and anticoagulation was stopped in 9/16 (56.25%) whose aneurysms regressed.","limitations":"Single-center retrospective series with small sample (n=18) and referral bias toward severe cases; short follow-up with two lost to follow-up; institutional risk stratification and expanded IVIg-resistance criteria were unvalidated.","practice_takeaway":"In this LMIC cohort, mixed outcomes and a death occurred, with many children diagnosed after day 10 and intensification delayed, underscoring the need for early recognition, risk stratification, serial echocardiography, and timely step-up immunosuppression in high-risk or IVIg-resistant Kawasaki disease."}},{"doi":"10.1016/j.cgh.2025.11.017","pmid":"41285264","title":"Endoscopic response to subcutaneous infliximab by disease location: A post hoc analysis of the LIBERTY-CD study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2025-11-25T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2025.11.017","source_score":47,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-26","doi":"10.1016/j.cgh.2025.11.017","days":"14","issn":"1542-3565","rank":"3","field":"Clinical Medicine","score":"47","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1016/j.cgh.2025.11.017","title":"Endoscopic response to subcutaneous infliximab by disease location: A post hoc analysis of the LIBERTY-CD study.","journal":"Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association","methods":"","results":"Among 329 patients, 52.6% had colon-dominant CD (n=173) and 47.4% had ileum-dominant CD (n=105). Baseline characteristics were comparable between groups. At W54, IFX SC significantly improved all efficacy endpoints versus PBO, even though PBO-treated patients may have experienced residual treatment effects from intravenous IFX induction therapy. Treatment effects were similar regardless of disease location. In both location groups, clinical remission and endoscopic response at W54 correlated with higher serum IFX levels at W14 and W54. Endoscopic responses at W54 were greater with IFX SC versus PBO across all ileocolonic segments, including the terminal ileum, with consistent treatment effect sizes observed throughout each segment.","abstract":"$33","keywords":["CT-P13","Crohn’s disease","disease location","ileum-dominant","infliximab-dyyb"],"pubmed_id":"41285264","conclusions":"","publication_date":"2025-11-25T00:00:00"},"crossref":{"DOI":"10.1016/j.cgh.2025.11.017","URL":"https://doi.org/10.1016/j.cgh.2025.11.017","ISSN":["1542-3565"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S1542356525010018?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S1542356525010018?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Endoscopic response to subcutaneous infliximab by disease location: A post hoc analysis of the LIBERTY-CD study"],"author":[{"given":"Bruce E.","family":"Sands","sequence":"first","affiliation":[]},{"given":"Stefan","family":"Schreiber","sequence":"additional","affiliation":[]},{"given":"Marla C.","family":"Dubinsky","sequence":"additional","affiliation":[]},{"given":"Geert","family":"D’Haens","sequence":"additional","affiliation":[]},{"given":"Bincy P.","family":"Abraham","sequence":"additional","affiliation":[]},{"given":"Miguel","family":"Regueiro","sequence":"additional","affiliation":[]},{"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[]},{"given":"Hyunsoo","family":"Park","sequence":"additional","affiliation":[]},{"given":"Dong-Hyeon","family":"Kim","sequence":"additional","affiliation":[]},{"given":"Young Nam","family":"Lee","sequence":"additional","affiliation":[]},{"given":"Stephen B.","family":"Hanauer","sequence":"additional","affiliation":[]},{"given":"Jean-Frédéric","family":"Colombel","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,11]]},"member":"78","prefix":"10.1016","source":"Crossref","volume":null,"created":{"date-time":"2025-11-22T16:12:39Z","timestamp":1763827959000,"date-parts":[[2025,11,22]]},"indexed":{"date-time":"2025-11-28T07:51:09Z","timestamp":1764316269276,"date-parts":[[2025,11,28]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000,"date-parts":[[2025,11,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000,"date-parts":[[2025,11,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"http://creativecommons.org/licenses/by/4.0/","start":{"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000,"date-parts":[[2025,11,28]]},"delay-in-days":27,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S1542356525010018"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"Endoscopic response to subcutaneous infliximab by disease location: A post hoc analysis of the LIBERTY-CD study"},{"name":"journaltitle","label":"Journal Title","value":"Clinical Gastroenterology and Hepatology"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1016/j.cgh.2025.11.017"},{"name":"associatedlink","label":"CrossRef DOI link to the associated document","value":"https://doi.org/10.1016/j.cgh.2025.07.009"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2025 by the AGA Institute"}],"deposited":{"date-time":"2025-11-28T07:47:12Z","timestamp":1764316032000,"date-parts":[[2025,11,28]]},"issn-type":[{"type":"print","value":"1542-3565"}],"published":{"date-parts":[[2025,11]]},"publisher":"Elsevier BV","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1016/elsevier_cm_policy","alternative-id":["S1542356525010018"],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2025,11]]},"reference-count":0,"published-online":null,"references-count":0,"short-container-title":["Clinical Gastroenterology and Hepatology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1016/j.cgh.2025.11.017","is_oa":true,"title":"Endoscopic response to subcutaneous infliximab by disease location: A post hoc analysis of the LIBERTY-CD study","updated":"2025-12-01T01:08:31+00:00","published_date":"2025-11-01","best_oa_location":{"url":"https://doi.org/10.1016/j.cgh.2025.11.017","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1016/j.cgh.2025.11.017"}}},"created_at":"2025-12-08T12:24:58.509Z","updated_at":"2025-12-08T12:24:58.509Z","tags":[{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"sample_size","value":"n=329","value_numeric":329},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"warning","value":"No effect sizes or event rates were reported in the provided text.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"warning","value":"Placebo group may retain residual effects from IV induction, complicating comparisons.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"warning","value":"Post hoc analysis of RCT maintenance responders; design label as RCT may be imprecise.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2025.11.017","tag_type":"warning","value":"Subgroup counts appear inconsistent with total N (173 + 105 ≠ 329).","value_numeric":null}],"summaries":{"what_studied":"Post hoc analysis of the phase 3 LIBERTY-CD maintenance trial: Week 10 responders to intravenous infliximab induction were randomized to subcutaneous infliximab 120 mg every other week versus placebo and followed to Week 54, assessing outcomes by disease location (ileum-dominant vs colon-dominant) and segment-level endoscopic response, plus associations with serum infliximab levels.","key_result":"At Week 54, subcutaneous infliximab significantly improved all efficacy endpoints versus placebo, with similar treatment effects regardless of disease location. Endoscopic responses were greater with subcutaneous infliximab across all ileocolonic segments, including the terminal ileum; clinical remission and endoscopic response correlated with higher serum infliximab levels at Weeks 14 and 54.","limitations":"Post hoc subgroup analysis limited to induction responders; placebo patients may have residual effects from prior IV infliximab; no numeric effect sizes or event rates were reported in the provided text.","practice_takeaway":"For moderate-to-severe Crohn’s disease responders to IV induction, subcutaneous infliximab maintenance improves outcomes versus placebo regardless of ileal or colonic predominance, including the terminal ileum. Disease location alone should not deter choosing subcutaneous infliximab for maintenance in responders."}},{"doi":"10.1053/j.gastro.2025.09.038","pmid":"41274746","title":"AGA Living Clinical Practice Guideline on the Pharmacologic Management of Moderate-to-Severe Crohn’s Disease","journal_title":"Gastroenterology","journal_issn":"0016-5085","published_at":"2025-11-23T00:00:00.000Z","url":"https://doi.org/10.1053/j.gastro.2025.09.038","source_score":101,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-22","doi":"10.1053/j.gastro.2025.09.038","days":"14","issn":"0016-5085","rank":"1","field":"Clinical Medicine","score":"101","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1053/j.gastro.2025.09.038","title":"AGA Living Clinical Practice Guideline on the Pharmacologic Management of Moderate-to-Severe Crohn's Disease.","journal":"Gastroenterology","methods":"","results":"$34","abstract":"$35","keywords":["Evidence Synthesis","Inflammatory Bowel Disease","Network Meta-Analysis","Positioning"],"pubmed_id":"41274746","conclusions":"","publication_date":"2025-11-23T00:00:00"},"crossref":{"DOI":"10.1053/j.gastro.2025.09.038","URL":"https://doi.org/10.1053/j.gastro.2025.09.038","ISSN":["0016-5085"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0016508525060913?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0016508525060913?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"1397-1448","type":"journal-article","issue":"7","score":1,"title":["AGA Living Clinical Practice Guideline on the Pharmacologic Management of Moderate-to-Severe Crohn’s Disease"],"author":[{"given":"Frank I.","family":"Scott","sequence":"first","affiliation":[]},{"given":"Ashwin N.","family":"Ananthakrishnan","sequence":"additional","affiliation":[]},{"given":"Benjamin","family":"Click","sequence":"additional","affiliation":[]},{"given":"Manasi","family":"Agrawal","sequence":"additional","affiliation":[]},{"given":"Gaurav","family":"Syal","sequence":"additional","affiliation":[]},{"given":"John P.","family":"Haydek","sequence":"additional","affiliation":[]},{"given":"Yuhong","family":"Yuan","sequence":"additional","affiliation":[]},{"given":"Michael D.","family":"Kappelman","sequence":"additional","affiliation":[]},{"given":"James D.","family":"Lewis","sequence":"additional","affiliation":[]},{"given":"Siddharth","family":"Singh","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,12]]},"member":"78","prefix":"10.1053","source":"Crossref","volume":"169","created":{"date-time":"2025-11-20T15:58:29Z","timestamp":1763654309000,"date-parts":[[2025,11,20]]},"indexed":{"date-time":"2025-12-02T01:27:12Z","timestamp":1764638832344,"date-parts":[[2025,12,2]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S0016508525060913"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"AGA Living Clinical Practice Guideline on the Pharmacologic Management of Moderate-to-Severe Crohn’s Disease"},{"name":"journaltitle","label":"Journal Title","value":"Gastroenterology"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1053/j.gastro.2025.09.038"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2025 by the AGA Institute."}],"deposited":{"date-time":"2025-12-02T01:24:45Z","timestamp":1764638685000,"date-parts":[[2025,12,2]]},"issn-type":[{"type":"print","value":"0016-5085"}],"published":{"date-parts":[[2025,12]]},"publisher":"Elsevier BV","reference":[{"DOI":"10.15585/mmwr.mm6542a3","key":"10.1053/j.gastro.2025.09.038_bib1","year":"2016","issue":null,"author":"Dahlhamer","volume":"65","first-page":"1166","unstructured":null,"article-title":"Prevalence of inflammatory bowel disease among adults aged ≥18 years — United States, 2015","journal-title":"MMWR Morb Mortal Wkly Rep","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2468-1253(19)30333-4","key":"10.1053/j.gastro.2025.09.038_bib2","year":"2020","issue":null,"author":null,"volume":"5","first-page":"17","unstructured":null,"article-title":"The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","journal-title":"Lancet Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2023.07.003","key":"10.1053/j.gastro.2025.09.038_bib3","year":"2023","issue":null,"author":"Lewis","volume":"165","first-page":"1197","unstructured":null,"article-title":"Incidence, prevalence, and racial and ethnic distribution of inflammatory bowel disease in the United States","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2013-305607","key":"10.1053/j.gastro.2025.09.038_bib4","year":"2014","issue":null,"author":"Rungoe","volume":"63","first-page":"1607","unstructured":null,"article-title":"Changes in medical treatment and surgery rates in inflammatory bowel disease: a nationwide cohort study 1979–2011","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1007/s10620-021-07200-1","key":"10.1053/j.gastro.2025.09.038_bib5","year":"2022","issue":null,"author":"Tsai","volume":"67","first-page":"2451","unstructured":null,"article-title":"Systematic review and meta-analysis: risk of hospitalization in patients with ulcerative colitis and Crohn's Disease in population-based cohort studies","journal-title":"Dig Dis Sci","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2021.04.023","key":"10.1053/j.gastro.2025.09.038_bib6","year":"2021","issue":null,"author":"Singh","volume":"160","first-page":"2512","unstructured":null,"article-title":"AGA technical review on the medical management of moderate to severe luminal and perianal fistulizing Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2016-312648","key":"10.1053/j.gastro.2025.09.038_bib7","year":"2018","issue":null,"author":"Siegel","volume":"67","first-page":"244","unstructured":null,"article-title":"Development of an index to define overall disease severity in IBD","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2014.07.022","key":"10.1053/j.gastro.2025.09.038_bib8","year":"2014","issue":null,"author":"Sandborn","volume":"147","first-page":"702","unstructured":null,"article-title":"Crohn’s disease evaluation and treatment: clinical decision tool","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2013.02.001","key":"10.1053/j.gastro.2025.09.038_bib9","year":"2013","issue":null,"author":"Sultan","volume":"11","first-page":"329","unstructured":null,"article-title":"The AGA institute process for developing clinical practice guidelines part one: grading the evidence","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2025.08.032","key":"10.1053/j.gastro.2025.09.038_bib10","year":"2025","issue":null,"author":"Singh","volume":"169","first-page":"1516","unstructured":null,"article-title":"Comparative efficacy of advanced therapies for management of moderate-to-severe Crohn’s disease: 2025 AGA evidence synthesis","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.7326/M22-0514","key":"10.1053/j.gastro.2025.09.038_bib11","year":"2022","issue":null,"author":"El Mikati","volume":"175","first-page":"1154","unstructured":null,"article-title":"A framework for the development of living practice guidelines in health care","journal-title":"Ann Intern Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2023.09.029","key":"10.1053/j.gastro.2025.09.038_bib12","year":"2023","issue":null,"author":"Ananthakrishnan","volume":"165","first-page":"1367","unstructured":null,"article-title":"AGA clinical practice guideline on the role of biomarkers for the management of Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.dld.2016.09.009","key":"10.1053/j.gastro.2025.09.038_bib13","year":"2017","issue":null,"author":"Casellas","volume":"49","first-page":"152","unstructured":null,"article-title":"Patient preferences for inflammatory bowel disease treatment objectives","journal-title":"Dig Liver Dis","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0016-5085(76)80163-1","key":"10.1053/j.gastro.2025.09.038_bib14","year":"1976","issue":null,"author":"Best","volume":"70","first-page":"439","unstructured":null,"article-title":"Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2024.10.001","key":"10.1053/j.gastro.2025.09.038_bib15","year":"2024","issue":null,"author":"Singh","volume":"167","first-page":"1307","unstructured":null,"article-title":"AGA living clinical practice guideline on pharmacological management of moderate-to-severe ulcerative colitis","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/0197-2456(86)90046-2","key":"10.1053/j.gastro.2025.09.038_bib16","year":"1986","issue":null,"author":"DerSimonian","volume":"7","first-page":"177","unstructured":null,"article-title":"Meta-analysis in clinical trials","journal-title":"Control Clin Trials","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2024.10.009","key":"10.1053/j.gastro.2025.09.038_bib17","year":"2025","issue":null,"author":"Solitano","volume":"168","first-page":"344","unstructured":null,"article-title":"Placebo rates in Crohn's disease randomized clinical trials: an individual patient data meta-analysis","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1136/bmj.327.7414.557","key":"10.1053/j.gastro.2025.09.038_bib18","year":"2003","issue":null,"author":"Higgins","volume":"327","first-page":"557","unstructured":null,"article-title":"Measuring inconsistency in meta-analyses","journal-title":"BMJ","doi-asserted-by":"crossref"},{"DOI":"10.1136/bmj.d4002","key":"10.1053/j.gastro.2025.09.038_bib19","year":"2011","issue":null,"author":"Sterne","volume":"343","first-page":null,"unstructured":null,"article-title":"Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials","journal-title":"BMJ","doi-asserted-by":"crossref"},{"DOI":"10.1136/bmj-2022-074495","key":"10.1053/j.gastro.2025.09.038_bib20","year":"2023","issue":null,"author":"Izcovich","volume":"381","first-page":null,"unstructured":null,"article-title":"A guide and pragmatic considerations for applying GRADE to network meta-analysis","journal-title":"BMJ","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.jclinepi.2017.10.005","key":"10.1053/j.gastro.2025.09.038_bib21","year":"2018","issue":null,"author":"Brignardello-Petersen","volume":"93","first-page":"36","unstructured":null,"article-title":"Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis","journal-title":"J Clin Epidemiol","doi-asserted-by":"crossref"},{"DOI":"10.1093/ibd/izaf085","key":"10.1053/j.gastro.2025.09.038_bib22","year":"2025","issue":null,"author":"Gordon","volume":"31","first-page":"2798","unstructured":null,"article-title":"Developing IBD outcome effect size thresholds to inform research, guidelines, and clinical decisions","journal-title":"Inflamm Bowel Dis","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib23","year":"2016","issue":null,"author":"Alonso-Coello","volume":"353","first-page":null,"unstructured":null,"article-title":"GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction","journal-title":"BMJ","doi-asserted-by":null},{"DOI":"10.1016/S2468-1253(20)30300-9","key":"10.1053/j.gastro.2025.09.038_bib24","year":"2020","issue":null,"author":"Fairbrass","volume":"5","first-page":"1053","unstructured":null,"article-title":"Prevalence of irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease in remission: a systematic review and meta-analysis","journal-title":"Lancet Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1007/s11938-021-00364-9","key":"10.1053/j.gastro.2025.09.038_bib25","year":"2021","issue":null,"author":"Hashash","volume":"19","first-page":"583","unstructured":null,"article-title":"Health maintenance for adult patients with inflammatory bowel disease","journal-title":"Cur Treat Options Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2009.11.024","key":"10.1053/j.gastro.2025.09.038_bib26","year":"2010","issue":null,"author":"Long","volume":"8","first-page":"268","unstructured":null,"article-title":"Increased risk for non-melanoma skin cancer in patients with inflammatory bowel disease","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2012.05.004","key":"10.1053/j.gastro.2025.09.038_bib27","year":"2012","issue":null,"author":"Long","volume":"143","first-page":"390","unstructured":null,"article-title":"Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1001/jama.2017.16071","key":"10.1053/j.gastro.2025.09.038_bib28","year":"2017","issue":null,"author":"Lemaitre","volume":"318","first-page":"1679","unstructured":null,"article-title":"Association between use of thiopurines or tumor necrosis factor antagonists alone or in combination and risk of lymphoma in patients with inflammatory bowel disease","journal-title":"JAMA","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa2109927","key":"10.1053/j.gastro.2025.09.038_bib29","year":"2022","issue":null,"author":"Ytterberg","volume":"386","first-page":"316","unstructured":null,"article-title":"Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1038/ajg.2015.233","key":"10.1053/j.gastro.2025.09.038_bib30","year":"2015","issue":null,"author":"Peyrin-Biroulet","volume":"110","first-page":"1324","unstructured":null,"article-title":"Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): determining therapeutic goals for treat-to-target","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2020.12.031","key":"10.1053/j.gastro.2025.09.038_bib31","year":"2021","issue":null,"author":"Turner","volume":"160","first-page":"1570","unstructured":null,"article-title":"STRIDE-II: an update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJM199710093371502","key":"10.1053/j.gastro.2025.09.038_bib32","year":"1997","issue":null,"author":"Targan","volume":"337","first-page":"1029","unstructured":null,"article-title":"A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. Crohn's Disease cA2 Study Group","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2006.02.014","key":"10.1053/j.gastro.2025.09.038_bib33","year":"2006","issue":null,"author":"Lemann","volume":"130","first-page":"1054","unstructured":null,"article-title":"Infliximab plus azathioprine for steroid-dependent Crohn's disease patients: a randomized placebo-controlled trial","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(02)08512-4","key":"10.1053/j.gastro.2025.09.038_bib34","year":"2002","issue":null,"author":"Hanauer","volume":"359","first-page":"1541","unstructured":null,"article-title":"Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2024.05.006","key":"10.1053/j.gastro.2025.09.038_bib35","year":"2024","issue":null,"author":"Hanauer","volume":"167","first-page":"919","unstructured":null,"article-title":"Subcutaneous infliximab (CT-P13 SC) as maintenance therapy for inflammatory bowel disease: two randomized phase 3 trials (LIBERTY)","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0016-5085(99)70332-X","key":"10.1053/j.gastro.2025.09.038_bib36","year":"1999","issue":null,"author":"Rutgeerts","volume":"117","first-page":"761","unstructured":null,"article-title":"Efficacy and safety of retreatment with anti-tumor necrosis factor antibody (infliximab) to maintain remission in Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2005.11.030","key":"10.1053/j.gastro.2025.09.038_bib37","year":"2006","issue":null,"author":"Hanauer","volume":"130","first-page":"323","unstructured":null,"article-title":"Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn's disease: the CLASSIC-I trial","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1136/gut.2006.106781","key":"10.1053/j.gastro.2025.09.038_bib38","year":"2007","issue":null,"author":"Sandborn","volume":"56","first-page":"1232","unstructured":null,"article-title":"Adalimumab for maintenance treatment of Crohn's disease: results of the CLASSIC II trial","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.crohns.2011.07.013","key":"10.1053/j.gastro.2025.09.038_bib39","year":"2012","issue":null,"author":"Watanabe","volume":"6","first-page":"160","unstructured":null,"article-title":"Adalimumab for the induction and maintenance of clinical remission in Japanese patients with Crohn's disease","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"},{"DOI":"10.1177/1756284820938960","key":"10.1053/j.gastro.2025.09.038_bib40","year":"2020","issue":null,"author":"Chen","volume":"13","first-page":null,"unstructured":null,"article-title":"Efficacy and safety of adalimumab in Chinese patients with moderately to severely active Crohn's disease: results from a randomized trial","journal-title":"Ther Adv Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.7326/0003-4819-146-12-200706190-00159","key":"10.1053/j.gastro.2025.09.038_bib41","year":"2007","issue":null,"author":"Sandborn","volume":"146","first-page":"829","unstructured":null,"article-title":"Adalimumab induction therapy for Crohn disease previously treated with infliximab: a randomized trial","journal-title":"Ann Intern Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2006.11.041","key":"10.1053/j.gastro.2025.09.038_bib42","year":"2007","issue":null,"author":"Colombel","volume":"132","first-page":"52","unstructured":null,"article-title":"Adalimumab for maintenance of clinical response and remission in patients with Crohn's disease: the CHARM trial","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2012.01.035","key":"10.1053/j.gastro.2025.09.038_bib43","year":"2012","issue":null,"author":"Rutgeerts","volume":"142","first-page":"1102","unstructured":null,"article-title":"Adalimumab induces and maintains mucosal healing in patients with Crohn's disease: data from the EXTEND Trial","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa067594","key":"10.1053/j.gastro.2025.09.038_bib44","year":"2007","issue":null,"author":"Sandborn","volume":"357","first-page":"228","unstructured":null,"article-title":"Certolizumab pegol for the treatment of Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa062897","key":"10.1053/j.gastro.2025.09.038_bib45","year":"2007","issue":null,"author":"Schreiber","volume":"357","first-page":"239","unstructured":null,"article-title":"Maintenance therapy with certolizumab pegol for Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2010.04.021","key":"10.1053/j.gastro.2025.09.038_bib46","year":"2010","issue":null,"author":"Sandborn","volume":"8","first-page":"688","unstructured":null,"article-title":"Certolizumab pegol in patients with moderate to severe Crohn's disease and secondary failure to infliximab","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa1215739","key":"10.1053/j.gastro.2025.09.038_bib47","year":"2013","issue":null,"author":"Sandborn","volume":"369","first-page":"711","unstructured":null,"article-title":"Vedolizumab as induction and maintenance therapy for Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2014.05.008","key":"10.1053/j.gastro.2025.09.038_bib48","year":"2014","issue":null,"author":"Sands","volume":"147","first-page":"618","unstructured":null,"article-title":"Effects of vedolizumab induction therapy for patients with Crohn's disease in whom tumor necrosis factor antagonist treatment failed","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1007/s00535-019-01647-w","key":"10.1053/j.gastro.2025.09.038_bib49","year":"2020","issue":null,"author":"Watanabe","volume":"55","first-page":"291","unstructured":null,"article-title":"Effects of vedolizumab in Japanese patients with Crohn's disease: a prospective, multicenter, randomized, placebo-controlled Phase 3 trial with exploratory analyses","journal-title":"J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1093/ecco-jcc/jjab133","key":"10.1053/j.gastro.2025.09.038_bib50","year":"2022","issue":null,"author":"Vermeire","volume":"16","first-page":"27","unstructured":null,"article-title":"Efficacy and safety of subcutaneous vedolizumab in patients with moderately to severely active Crohn's disease: results from the VISIBLE 2 randomised trial","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa1203572","key":"10.1053/j.gastro.2025.09.038_bib51","year":"2012","issue":null,"author":"Sandborn","volume":"367","first-page":"1519","unstructured":null,"article-title":"Ustekinumab induction and maintenance therapy in refractory Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa1602773","key":"10.1053/j.gastro.2025.09.038_bib52","year":"2016","issue":null,"author":"Feagan","volume":"375","first-page":"1946","unstructured":null,"article-title":"Ustekinumab as induction and maintenance therapy for Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2008.07.014","key":"10.1053/j.gastro.2025.09.038_bib53","year":"2008","issue":null,"author":"Sandborn","volume":"135","first-page":"1130","unstructured":null,"article-title":"A randomized trial of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with moderate-to-severe Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0016-5085(24)05019-4","key":"10.1053/j.gastro.2025.09.038_bib54","year":"2024","issue":null,"author":"Panaccione","volume":"166","first-page":"1057b2","unstructured":null,"article-title":"Efficacy and safety of guselkumab therapy in patients with moderately to severely active Crohn's disease: results of the GALAXI 2 & 3 phase 3 studies","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2022.01.047","key":"10.1053/j.gastro.2025.09.038_bib55","year":"2022","issue":null,"author":"Sandborn","volume":"162","first-page":"1650","unstructured":null,"article-title":"Guselkumab for the treatment of Crohn's disease: induction results from the phase 2 GALAXI-1 study","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(24)01762-8","key":"10.1053/j.gastro.2025.09.038_bib56","year":"2024","issue":null,"author":"Ferrante","volume":"404","first-page":"2423","unstructured":null,"article-title":"Efficacy and safety of mirikizumab in patients with moderately-to-severely active Crohn's disease: a phase 3, multicentre, randomised, double-blind, placebo-controlled and active-controlled, treat-through study","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2021.10.050","key":"10.1053/j.gastro.2025.09.038_bib57","year":"2022","issue":null,"author":"Sands","volume":"162","first-page":"495","unstructured":null,"article-title":"Efficacy and safety of mirikizumab in a randomized phase 2 study of patients with Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2025.02.033","key":"10.1053/j.gastro.2025.09.038_bib58","year":"2025","issue":null,"author":"Hart","volume":"169","first-page":"308","unstructured":null,"article-title":"Efficacy and safety of guselkumab subcutaneous induction and maintenance in participants with moderately to severely active Crohn’s disease: results from the phase 3 GRAVITI study","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(22)00467-6","key":"10.1053/j.gastro.2025.09.038_bib59","year":"2022","issue":null,"author":"D'Haens","volume":"399","first-page":"2015","unstructured":null,"article-title":"Risankizumab as induction therapy for Crohn's disease: results from the phase 3 ADVANCE and MOTIVATE induction trials","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(17)30570-6","key":"10.1053/j.gastro.2025.09.038_bib60","year":"2017","issue":null,"author":"Feagan","volume":"389","first-page":"1699","unstructured":null,"article-title":"Induction therapy with the selective interleukin-23 inhibitor risankizumab in patients with moderate-to-severe Crohn's disease: a randomised, double-blind, placebo-controlled phase 2 study","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(22)00466-4","key":"10.1053/j.gastro.2025.09.038_bib61","year":"2022","issue":null,"author":"Ferrante","volume":"399","first-page":"2031","unstructured":null,"article-title":"Risankizumab as maintenance therapy for moderately to severely active Crohn's disease: results from the multicentre, randomised, double-blind, placebo-controlled, withdrawal phase 3 FORTIFY maintenance trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa2212728","key":"10.1053/j.gastro.2025.09.038_bib62","year":"2023","issue":null,"author":"Loftus","volume":"388","first-page":"1966","unstructured":null,"article-title":"Upadacitinib induction and maintenance therapy for Crohn’s disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2020.01.047","key":"10.1053/j.gastro.2025.09.038_bib63","year":"2020","issue":null,"author":"Sandborn","volume":"158","first-page":"2123","unstructured":null,"article-title":"Efficacy and safety of upadacitinib in a randomized trial of patients with Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1093/ecco-jcc/jjad100","key":"10.1053/j.gastro.2025.09.038_bib64","year":"2023","issue":null,"author":"Solitano","volume":"17","first-page":"1800","unstructured":null,"article-title":"Efficacy and safety of advanced oral small molecules for inflammatory bowel disease: systematic review and meta-analysis","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"},{"DOI":"10.1038/ajg.2016.433","key":"10.1053/j.gastro.2025.09.038_bib66","year":"2016","issue":null,"author":"Osterman","volume":"111","first-page":"1806","unstructured":null,"article-title":"Crohn's disease activity and concomitant immunosuppressants affect the risk of serious and opportunistic infections in patients treated with adalimumab","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1038/ajg.2012.218","key":"10.1053/j.gastro.2025.09.038_bib67","year":"2012","issue":null,"author":"Lichtenstein","volume":"107","first-page":"1409","unstructured":null,"article-title":"Serious infection and mortality in patients with Crohn's disease: more than 5 years of follow-up in the TREAT registry","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2024.01.003","key":"10.1053/j.gastro.2025.09.038_bib68","year":"2024","issue":null,"author":"Ahuja","volume":"22","first-page":"1286","unstructured":null,"article-title":"Impact of treatment response on risk of serious infections in patients with Crohn's disease: secondary analysis of the PYRAMID registry","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1093/ibd/izy321","key":"10.1053/j.gastro.2025.09.038_bib69","year":"2019","issue":null,"author":"Scott","volume":"25","first-page":"925","unstructured":null,"article-title":"Improved quality of life with anti-TNF therapy compared with continued corticosteroid utilization in Crohn's disease","journal-title":"Inflamm Bowel Dis","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2019.05.010","key":"10.1053/j.gastro.2025.09.038_bib70","year":"2020","issue":null,"author":"Bewtra","volume":"18","first-page":"406","unstructured":null,"article-title":"Variation among patients with Crohn's disease in benefit vs risk preferences and remission time equivalents","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.14309/ctg.0000000000000629","key":"10.1053/j.gastro.2025.09.038_bib71","year":"2023","issue":null,"author":"Hanzel","volume":"14","first-page":null,"unstructured":null,"article-title":"A comparison of treatment effect sizes in matched phase 2 and phase 3 trials of advanced therapeutics in inflammatory bowel disease: systematic review and meta-analysis","journal-title":"Clin Transl Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(17)30068-5","key":"10.1053/j.gastro.2025.09.038_bib72","year":"2017","issue":null,"author":"Jorgensen","volume":"389","first-page":"2304","unstructured":null,"article-title":"Switching from originator infliximab to biosimilar CT-P13 compared with maintained treatment with originator infliximab (NOR-SWITCH): a 52-week, randomised, double-blind, non-inferiority trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib73","year":"2025","issue":"Suppl 1","author":"Elosua Gonzalez","volume":"19","first-page":null,"unstructured":null,"article-title":"P0990 Real-world effectiveness of upadacitinib induction therapy in Crohn’s disease, with a focus on patients with concomitant IMIDs","journal-title":"J Crohns Colitis","doi-asserted-by":null},{"DOI":"10.14309/01.ajg.0001034600.37922.a6","key":"10.1053/j.gastro.2025.09.038_bib74","year":"2024","issue":"Suppl","author":"Axenfeld","volume":"119","first-page":"S936","unstructured":null,"article-title":"S1308 Treatment outcomes of prolonged induction or re-escalation dosing of upadacitinib in patients with inflammatory bowel disease","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2024.12.023","key":"10.1053/j.gastro.2025.09.038_bib75","year":"2025","issue":null,"author":"Panaccione","volume":"23","first-page":"2012","unstructured":null,"article-title":"Extended risankizumab treatment in patients with Crohn's disease who did not achieve clinical response to induction treatment","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib76","year":"2025","issue":"Suppl","author":"Afzali","volume":"13","first-page":"S576","unstructured":null,"article-title":"Abstract MP582. Guselkumab maintenance dose regimens in patients with high disease activity and severity: subgroup analysis of participants with moderately to severely active Crohn's disease in the GALAXI phase 3 studies","journal-title":"United European Gastroenterol J","doi-asserted-by":null},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib77","year":"2022","issue":null,"author":"Alayo","volume":"4","first-page":null,"unstructured":null,"article-title":"Systematic review with meta-analysis: safety and effectiveness of combining biologics and small molecules in inflammatory bowel disease","journal-title":"Crohns Colitis 360","doi-asserted-by":null},{"DOI":"10.1016/j.cgh.2024.05.051","key":"10.1053/j.gastro.2025.09.038_bib78","year":"2025","issue":null,"author":"Battat","volume":"23","first-page":"469","unstructured":null,"article-title":"IBD matchmaking: rational combination therapy","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2011.04.031","key":"10.1053/j.gastro.2025.09.038_bib79","year":"2011","issue":null,"author":"Sandborn","volume":"9","first-page":"670","unstructured":null,"article-title":"Certolizumab pegol for active Crohn's disease: a placebo-controlled, randomized trial","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(22)00688-2","key":"10.1053/j.gastro.2025.09.038_bib80","year":"2022","issue":null,"author":"Sands","volume":"399","first-page":"2200","unstructured":null,"article-title":"Ustekinumab versus adalimumab for induction and maintenance therapy in biologic-naive patients with moderately to severely active Crohn's disease: a multicentre, randomised, double-blind, parallel-group, phase 3b trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa2314585","key":"10.1053/j.gastro.2025.09.038_bib81","year":"2024","issue":null,"author":"Peyrin-Biroulet","volume":"391","first-page":"213","unstructured":null,"article-title":"Risankizumab versus ustekinumab for moderate-to-severe Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2025.07.009","key":"10.1053/j.gastro.2025.09.038_bib82","year":"2025","issue":null,"author":"Lee","volume":null,"first-page":null,"unstructured":null,"article-title":"Efficacy of advanced therapies in achieving remission by disease location in Crohn's disease: a systematic review and meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2024-334395","key":"10.1053/j.gastro.2025.09.038_bib83","year":"2025","issue":"Suppl 2","author":"Moran","volume":"74","first-page":"s1","unstructured":null,"article-title":"British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2023.12.023","key":"10.1053/j.gastro.2025.09.038_bib84","year":"2024","issue":null,"author":"Vuyyuru","volume":"22","first-page":"1190","unstructured":null,"article-title":"Comparative efficacy of advanced therapies for achieving endoscopic outcomes in crohn's disease: a systematic review and network meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2019.11.267","key":"10.1053/j.gastro.2025.09.038_bib85","year":"2020","issue":null,"author":"Dolinger","volume":"158","first-page":null,"unstructured":null,"article-title":"P082 Anti-TNF efficacy after primary vedolizumab failure in pediatric inflammatory bowel disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1093/ecco-jcc/jjab058","key":"10.1053/j.gastro.2025.09.038_bib86","year":"2021","issue":null,"author":"Bressler","volume":"15","first-page":"1694","unstructured":null,"article-title":"Vedolizumab and anti-tumour necrosis factor α real-world outcomes in biologic-naïve inflammatory bowel disease patients: results from the EVOLVE study","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"},{"DOI":"10.14309/ajg.0000000000002553","key":"10.1053/j.gastro.2025.09.038_bib87","year":"2024","issue":null,"author":"Chugh","volume":"119","first-page":"468","unstructured":null,"article-title":"Maternal and neonatal outcomes in vedolizumab- and ustekinumab-exposed pregnancies: results from the PIANO registry","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2024.06.050","key":"10.1053/j.gastro.2025.09.038_bib88","year":"2025","issue":null,"author":"Fudman","volume":"23","first-page":"454","unstructured":null,"article-title":"Modern advanced therapies for inflammatory bowel diseases: practical considerations and positioning","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2468-1253(25)00017-2","key":"10.1053/j.gastro.2025.09.038_bib89","year":"2025","issue":null,"author":"Panaccione","volume":"10","first-page":"507","unstructured":null,"article-title":"Long-term efficacy and safety of upadacitinib in patients with moderately to severely active ulcerative colitis: an interim analysis of the phase 3 U-ACTIVATE long-term extension study","journal-title":"Lancet Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2021.12.030","key":"10.1053/j.gastro.2025.09.038_bib90","year":"2022","issue":null,"author":"D’Haens","volume":"20","first-page":"2337","unstructured":null,"article-title":"Upadacitinib was efficacious and well-tolerated over 30 months in patients with Crohn’s disease in the CELEST extension study","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1111/bjd.20818","key":"10.1053/j.gastro.2025.09.038_bib91","year":"2022","issue":null,"author":"Gordon","volume":"186","first-page":"466","unstructured":null,"article-title":"Long-term safety of risankizumab from 17 clinical trials in patients with moderate-to-severe plaque psoriasis","journal-title":"Br J Dermatol","doi-asserted-by":"crossref"},{"DOI":"10.1093/ecco-jcc/jjab093","key":"10.1053/j.gastro.2025.09.038_bib92","year":"2021","issue":null,"author":"Ferrante","volume":"15","first-page":"2001","unstructured":null,"article-title":"Long-term safety and efficacy of risankizumab treatment in patients with Crohn's disease: results from the phase 2 open-label extension study","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"},{"DOI":"10.1136/gut.37.5.674","key":"10.1053/j.gastro.2025.09.038_bib93","year":"1995","issue":null,"author":"Candy","volume":"37","first-page":"674","unstructured":null,"article-title":"A controlled double blind study of azathioprine in the management of Crohn's disease","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1016/0016-5085(93)90709-L","key":"10.1053/j.gastro.2025.09.038_bib94","year":"1993","issue":null,"author":"Ewe","volume":"105","first-page":"367","unstructured":null,"article-title":"Azathioprine combined with prednisolone or monotherapy with prednisolone in active Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib95","year":"1997","issue":null,"author":"Oren","volume":"92","first-page":"2203","unstructured":null,"article-title":"Methotrexate in chronic active Crohn's disease: a double-blind, randomized, Israeli multicenter trial","journal-title":"Am J Gastroenterol","doi-asserted-by":null},{"DOI":"10.1111/j.1572-0241.2008.02024.x","key":"10.1053/j.gastro.2025.09.038_bib96","year":"2008","issue":null,"author":"Reinisch","volume":"103","first-page":"2284","unstructured":null,"article-title":"A multicenter, randomized, double-blind trial of everolimus versus azathioprine and placebo to maintain steroid-induced remission in patients with moderate-to-severe active Crohn's disease","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/0016-5085(79)90385-8","key":"10.1053/j.gastro.2025.09.038_bib97","year":"1979","issue":null,"author":"Summers","volume":"77","first-page":"847","unstructured":null,"article-title":"National Cooperative Crohn's Disease Study: results of drug treatment","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/gast.2000.18144","key":"10.1053/j.gastro.2025.09.038_bib98","year":"2000","issue":null,"author":"Markowitz","volume":"119","first-page":"895","unstructured":null,"article-title":"A multicenter trial of 6-mercaptopurine and prednisone in children with newly diagnosed Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(78)92524-2","key":"10.1053/j.gastro.2025.09.038_bib99","year":"1978","issue":null,"author":"O'Donoghue","volume":"2","first-page":"955","unstructured":null,"article-title":"Double-blind withdrawal trial of azathioprine as maintenance treatment for Crohn's disease","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2013.06.009","key":"10.1053/j.gastro.2025.09.038_bib100","year":"2013","issue":null,"author":"Panes","volume":"145","first-page":"766","unstructured":null,"article-title":"Early azathioprine therapy is no more effective than placebo for newly diagnosed Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJM199502023320503","key":"10.1053/j.gastro.2025.09.038_bib101","year":"1995","issue":null,"author":"Feagan","volume":"332","first-page":"292","unstructured":null,"article-title":"Methotrexate for the treatment of Crohn's disease. The North American Crohn's Study Group Investigators","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib102","year":"1999","issue":null,"author":"Arora","volume":"46","first-page":"1724","unstructured":null,"article-title":"Methotrexate in Crohn's disease: results of a randomized, double-blind, placebo-controlled trial","journal-title":"Hepatogastroenterology","doi-asserted-by":null},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib103","year":"2000","issue":null,"author":"Feagan","volume":null,"first-page":"342L1627","unstructured":null,"article-title":"A comparison of methotrexate with placebo for the maintenance of remission in Crohn's disease. North American Crohn's Study Group Investigators","journal-title":"N Engl J Med","doi-asserted-by":null},{"DOI":"10.1001/jamadermatol.2015.3029","key":"10.1053/j.gastro.2025.09.038_bib104","year":"2016","issue":null,"author":"Scott","volume":"152","first-page":"164","unstructured":null,"article-title":"Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer","journal-title":"JAMA Dermatol","doi-asserted-by":"crossref"},{"DOI":"10.1007/s00384-006-0202-x","key":"10.1053/j.gastro.2025.09.038_bib105","year":"2007","issue":null,"author":"Crispino","volume":"22","first-page":"553","unstructured":null,"article-title":"Hematological malignancies in chronic inflammatory bowel diseases: report of five cases and review of the literature","journal-title":"Int J Colorectal Dis","doi-asserted-by":"crossref"},{"DOI":"10.1001/jama.1971.03180310117023","key":"10.1053/j.gastro.2025.09.038_bib106","year":"1971","issue":null,"author":"Filip","volume":"216","first-page":"881","unstructured":null,"article-title":"Pulmonary and hepatic complications of methotrexate therapy of psoriasis","journal-title":"JAMA","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2014.05.015","key":"10.1053/j.gastro.2025.09.038_bib107","year":"2015","issue":null,"author":"Kotlyar","volume":"13","first-page":"847","unstructured":null,"article-title":"Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1038/ajg.2013.402","key":"10.1053/j.gastro.2025.09.038_bib108","year":"2014","issue":null,"author":"Chatu","volume":"109","first-page":"23","unstructured":null,"article-title":"The role of thiopurines in reducing the need for surgical resection in Crohn's disease: a systematic review and meta-analysis","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2017.07.032","key":"10.1053/j.gastro.2025.09.038_bib109","year":"2017","issue":null,"author":"Feuerstein","volume":"153","first-page":"827","unstructured":null,"article-title":"American Gastroenterological Association Institute guideline on therapeutic drug monitoring in inflammatory bowel disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2023.03.224","key":"10.1053/j.gastro.2025.09.038_bib110","year":"2023","issue":null,"author":"Kappelman","volume":"165","first-page":"149","unstructured":null,"article-title":"Comparative effectiveness of anti-TNF in combination with low-dose methotrexate vs anti-TNF monotherapy in pediatric Crohn's disease: a pragmatic randomized trial","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1056/NEJMoa0904492","key":"10.1053/j.gastro.2025.09.038_bib111","year":"2010","issue":null,"author":"Colombel","volume":"362","first-page":"1383","unstructured":null,"article-title":"Infliximab, azathioprine, or combination therapy for Crohn's disease","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2013.11.024","key":"10.1053/j.gastro.2025.09.038_bib112","year":"2014","issue":null,"author":"Feagan","volume":"146","first-page":"681","unstructured":null,"article-title":"Methotrexate in combination with infliximab is no more effective than infliximab alone in patients with Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1093/ecco-jcc/jjw152","key":"10.1053/j.gastro.2025.09.038_bib113","year":"2016","issue":null,"author":"Matsumoto","volume":"10","first-page":"1259","unstructured":null,"article-title":"Adalimumab monotherapy and a combination with azathioprine for Crohn's disease: a prospective, randomized trial","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2013.12.025","key":"10.1053/j.gastro.2025.09.038_bib114","year":"2014","issue":null,"author":"Osterman","volume":"146","first-page":"941","unstructured":null,"article-title":"Increased risk of malignancy with adalimumab combination therapy, compared with monotherapy, for Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2019.02.044","key":"10.1053/j.gastro.2025.09.038_bib115","year":"2020","issue":null,"author":"Singh","volume":"18","first-page":"69","unstructured":null,"article-title":"Comparative risk of serious infections with biologic and/or immunosuppressive therapy in patients with inflammatory bowel diseases: a systematic review and meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2015.06.034","key":"10.1053/j.gastro.2025.09.038_bib116","year":"2015","issue":null,"author":"Jones","volume":"13","first-page":"2233","unstructured":null,"article-title":"Effects of concomitant immunomodulator therapy on efficacy and safety of anti-tumor necrosis factor therapy for Crohn's disease: a meta-analysis of placebo-controlled trials","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1136/gut.2006.099978","key":"10.1053/j.gastro.2025.09.038_bib117","year":"2007","issue":null,"author":"Vermeire","volume":"56","first-page":"1226","unstructured":null,"article-title":"Effectiveness of concomitant immunosuppressive therapy in suppressing the formation of antibodies to infliximab in Crohn's disease","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2014.12.026","key":"10.1053/j.gastro.2025.09.038_bib118","year":"2015","issue":null,"author":"Yarur","volume":"13","first-page":"1118","unstructured":null,"article-title":"Concentrations of 6-thioguanine nucleotide correlate with trough levels of infliximab in patients with inflammatory bowel disease on combination therapy","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2022.10.016","key":"10.1053/j.gastro.2025.09.038_bib119","year":"2023","issue":null,"author":"Yarur","volume":"21","first-page":"2908","unstructured":null,"article-title":"Combination therapy with immunomodulators improves the pharmacokinetics of infliximab but not vedolizumab or ustekinumab","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2019.09.041","key":"10.1053/j.gastro.2025.09.038_bib120","year":"2020","issue":null,"author":"Sazonovs","volume":"158","first-page":"189","unstructured":null,"article-title":"HLA-DQA1∗05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2023.03.044","key":"10.1053/j.gastro.2025.09.038_bib121","year":"2023","issue":null,"author":"Solitano","volume":"21","first-page":"3019","unstructured":null,"article-title":"HLA-DQA1 ∗05 genotype and immunogenicity to tumor necrosis factor-alpha antagonists: a systematic review and meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2019-319758","key":"10.1053/j.gastro.2025.09.038_bib122","year":"2020","issue":null,"author":"Roblin","volume":"69","first-page":"1206","unstructured":null,"article-title":"Addition of azathioprine to the switch of anti-TNF in patients with IBD in clinical relapse with undetectable anti-TNF trough levels and antidrug antibodies: a prospective randomised trial","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1111/imj.16504","key":"10.1053/j.gastro.2025.09.038_bib123","year":"2024","issue":null,"author":"Yu","volume":"54","first-page":"1856","unstructured":null,"article-title":"6-Thioguanine nucleotide levels are associated with infliximab but not adalimumab levels in inflammatory bowel disease patients on combination therapy","journal-title":"Intern Med J","doi-asserted-by":"crossref"},{"DOI":"10.14309/ajg.0000000000003573","key":"10.1053/j.gastro.2025.09.038_bib124","year":"2025","issue":null,"author":"Solitano","volume":null,"first-page":null,"unstructured":null,"article-title":"Effectiveness and safety of advanced combination treatment in patients with refractory inflammatory bowel disease or concomitant immune-mediated disease or extraintestinal manifestations: a multicenter Canadian study","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2021.03.034","key":"10.1053/j.gastro.2025.09.038_bib125","year":"2022","issue":null,"author":"Ahmed","volume":"20","first-page":"e361","unstructured":null,"article-title":"Dual biologic or small molecule therapy for treatment of inflammatory bowel disease: a systematic review and meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2020.07.012","key":"10.1053/j.gastro.2025.09.038_bib126","year":"2021","issue":null,"author":"Hu","volume":"19","first-page":"1366","unstructured":null,"article-title":"Combination therapy does not improve rate of clinical or endoscopic remission in patients with inflammatory bowel diseases treated with vedolizumab or ustekinumab","journal-title":"Clin Gastroenterolo Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2020.06.071","key":"10.1053/j.gastro.2025.09.038_bib127","year":"2021","issue":null,"author":"Yzet","volume":"19","first-page":"668","unstructured":null,"article-title":"No benefit of concomitant immunomodulator therapy on efficacy of biologics that are not tumor necrosis factor antagonists in patients with inflammatory bowel diseases: a meta-analysis","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.3390/jcm9103142","key":"10.1053/j.gastro.2025.09.038_bib128","year":"2020","issue":null,"author":"Vaughn","volume":"9","first-page":"3142","unstructured":null,"article-title":"Vedolizumab serum trough concentrations and response to dose escalation in inflammatory bowel disease","journal-title":"J Clin Med","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2021.01.002","key":"10.1053/j.gastro.2025.09.038_bib129","year":"2021","issue":null,"author":"Shukla","volume":"19","first-page":"1108","unstructured":null,"article-title":"Therapeutic drug monitoring of non-anti-tumor necrosis factor biologics","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2022-327002","key":"10.1053/j.gastro.2025.09.038_bib130","year":"2022","issue":null,"author":"Kirchgesner","volume":"71","first-page":"1781","unstructured":null,"article-title":"Decreased risk of treatment failure with vedolizumab and thiopurines combined compared with vedolizumab monotherapy in Crohn's disease","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1007/s00535-019-01582-w","key":"10.1053/j.gastro.2025.09.038_bib131","year":"2019","issue":null,"author":"Hisamatsu","volume":"54","first-page":"860","unstructured":null,"article-title":"Withdrawal of thiopurines in Crohn's disease treated with scheduled adalimumab maintenance: a prospective randomised clinical trial (DIAMOND2)","journal-title":"J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1111/apt.14106","key":"10.1053/j.gastro.2025.09.038_bib132","year":"2017","issue":null,"author":"Roblin","volume":"46","first-page":"142","unstructured":null,"article-title":"Azathioprine dose reduction in inflammatory bowel disease patients on combination therapy: an open-label, prospective and randomised clinical trial","journal-title":"Aliment Pharmacol Ther","doi-asserted-by":"crossref"},{"DOI":"10.1097/MPG.0000000000000684","key":"10.1053/j.gastro.2025.09.038_bib133","year":"2015","issue":null,"author":"Kierkus","volume":"60","first-page":"580","unstructured":null,"article-title":"Monotherapy with infliximab versus combination therapy in the maintenance of clinical remission in children with moderate to severe Crohn disease","journal-title":"J Pediatr Gastroenterol Nutr","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2008.03.004","key":"10.1053/j.gastro.2025.09.038_bib134","year":"2008","issue":null,"author":"Van Assche","volume":"134","first-page":"1861","unstructured":null,"article-title":"Withdrawal of immunosuppression in Crohn's disease treated with scheduled infliximab maintenance: a randomized trial","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2024-333385","key":"10.1053/j.gastro.2025.09.038_bib135","year":"2025","issue":null,"author":"Gisbert","volume":"74","first-page":"387","unstructured":null,"article-title":"Withdrawal of antitumour necrosis factor in inflammatory bowel disease patients in remission: a randomised placebo-controlled clinical trial of GETECCU","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2468-1253(22)00385-5","key":"10.1053/j.gastro.2025.09.038_bib136","year":"2023","issue":null,"author":"Louis","volume":"8","first-page":"215","unstructured":null,"article-title":"Withdrawal of infliximab or concomitant immunosuppressant therapy in patients with Crohn's disease on combination therapy (SPARE): a multicentre, open-label, randomised controlled trial","journal-title":"Lancet Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1056/EVIDoa2200061","key":"10.1053/j.gastro.2025.09.038_bib137","year":"2022","issue":null,"author":"Buhl","volume":"1","first-page":null,"unstructured":null,"article-title":"Discontinuation of infliximab therapy in patients with Crohn's disease","journal-title":"NEJM Evid","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2018.04.012","key":"10.1053/j.gastro.2025.09.038_bib138","year":"2018","issue":null,"author":"Kirchgesner","volume":"155","first-page":"337","unstructured":null,"article-title":"Risk of serious and opportunistic infections associated with treatment of inflammatory bowel diseases","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1136/bmj.h2809","key":"10.1053/j.gastro.2025.09.038_bib139","year":"2015","issue":null,"author":"Nyboe Andersen","volume":"350","first-page":null,"unstructured":null,"article-title":"Association between tumour necrosis factor-alpha inhibitors and risk of serious infections in people with inflammatory bowel disease: nationwide Danish cohort study","journal-title":"BMJ","doi-asserted-by":"crossref"},{"DOI":"10.14309/ajg.0000000000001058","key":"10.1053/j.gastro.2025.09.038_bib140","year":"2021","issue":null,"author":"Khan","volume":"116","first-page":"741","unstructured":null,"article-title":"Incidence of acute myeloid leukemia and myelodysplastic syndrome in patients with inflammatory bowel disease and the impact of thiopurines on their risk","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2022.01.019","key":"10.1053/j.gastro.2025.09.038_bib141","year":"2022","issue":null,"author":"Mahmoud","volume":"20","first-page":"2577","unstructured":null,"article-title":"Immunomodulator withdrawal from anti-TNF therapy is not associated with loss of response in inflammatory bowel disease","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(08)60304-9","key":"10.1053/j.gastro.2025.09.038_bib142","year":"2008","issue":null,"author":"D'Haens","volume":"371","first-page":"660","unstructured":null,"article-title":"Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(15)00068-9","key":"10.1053/j.gastro.2025.09.038_bib143","year":"2015","issue":null,"author":"Khanna","volume":"386","first-page":"1825","unstructured":null,"article-title":"Early combined immunosuppression for the management of Crohn's disease (REACT): a cluster randomised controlled trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2468-1253(24)00034-7","key":"10.1053/j.gastro.2025.09.038_bib144","year":"2024","issue":null,"author":"Noor","volume":"9","first-page":"415","unstructured":null,"article-title":"A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn's disease (PROFILE): a multicentre, open-label randomised controlled trial","journal-title":"Lancet Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(17)30317-3","key":"10.1053/j.gastro.2025.09.038_bib145","year":"2017","issue":null,"author":"Kugathasan","volume":"389","first-page":"1710","unstructured":null,"article-title":"Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1001/jamanetworkopen.2020.7378","key":"10.1053/j.gastro.2025.09.038_bib146","year":"2020","issue":null,"author":"Adler","volume":"3","first-page":null,"unstructured":null,"article-title":"Association between steroid-sparing therapy and the risk of perianal fistulizing complications among young patients with Crohn disease","journal-title":"JAMA Netw Open","doi-asserted-by":"crossref"},{"DOI":"10.1136/gutjnl-2024-333280","key":"10.1053/j.gastro.2025.09.038_bib147","year":"2025","issue":null,"author":"Adler","volume":"74","first-page":"539","unstructured":null,"article-title":"Early tumour necrosis factor antagonist treatment prevents perianal fistula development in children with Crohn's disease: post hoc analysis of the RISK study","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1542/peds.2021-052501","key":"10.1053/j.gastro.2025.09.038_bib148","year":"2022","issue":null,"author":"Constant","volume":"149","first-page":null,"unstructured":null,"article-title":"Delays related to prior authorization in inflammatory bowel disease","journal-title":"Pediatrics","doi-asserted-by":"crossref"},{"DOI":"10.1016/S2468-1253(21)00474-X","key":"10.1053/j.gastro.2025.09.038_bib149","year":"2022","issue":null,"author":"Danese","volume":"7","first-page":"294","unstructured":null,"article-title":"Treat to target versus standard of care for patients with Crohn's disease treated with ustekinumab (STARDUST): an open-label, multicentre, randomised phase 3b trial","journal-title":"Lancet Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1053/j.gastro.2025.09.038_bib150","year":"2022","issue":"Suppl 8","author":"Jairath","volume":"10","first-page":"89","unstructured":null,"article-title":"A cluster-randomised controlled trial of an enhanced treatment algorithm for the management of Crohn’s disease: REACT-2","journal-title":"United European Gastroenterol J","doi-asserted-by":null},{"DOI":"10.1136/gutjnl-2019-318256","key":"10.1053/j.gastro.2025.09.038_bib151","year":"2020","issue":null,"author":"Panaccione","volume":"69","first-page":"658","unstructured":null,"article-title":"Tight control for Crohn's disease with adalimumab-based treatment is cost-effective: an economic assessment of the CALM trial","journal-title":"Gut","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(17)32641-7","key":"10.1053/j.gastro.2025.09.038_bib152","year":"2018","issue":null,"author":"Colombel","volume":"390","first-page":"2779","unstructured":null,"article-title":"Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1053/j.gastro.2020.03.039","key":"10.1053/j.gastro.2025.09.038_bib153","year":"2020","issue":null,"author":"Ungaro","volume":"159","first-page":"139","unstructured":null,"article-title":"Deep remission at 1 year prevents progression of early Crohn's disease","journal-title":"Gastroenterology","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2021.11.030","key":"10.1053/j.gastro.2025.09.038_bib154","year":"2022","issue":null,"author":"Laharie","volume":"20","first-page":"2074","unstructured":null,"article-title":"Steroid-free deep remission at one year does not prevent Crohn's disease progression: long-term data from the TAILORIX Trial","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(14)61908-5","key":"10.1053/j.gastro.2025.09.038_bib155","year":"2015","issue":null,"author":"De Cruz","volume":"385","first-page":"1406","unstructured":null,"article-title":"Crohn's disease management after intestinal resection: a randomised trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.cgh.2019.11.056","key":"10.1053/j.gastro.2025.09.038_bib156","year":"2020","issue":null,"author":"Christensen","volume":"18","first-page":"2518","unstructured":null,"article-title":"Histologic healing is more strongly associated with clinical outcomes in ileal Crohn's disease than endoscopic healing","journal-title":"Clin Gastroenterol Hepatol","doi-asserted-by":"crossref"},{"DOI":"10.1111/apt.15190","key":"10.1053/j.gastro.2025.09.038_bib157","year":"2019","issue":null,"author":"Castiglione","volume":"49","first-page":"1026","unstructured":null,"article-title":"One-year clinical outcomes with biologics in Crohn's disease: transmural healing compared with mucosal or no healing","journal-title":"Aliment Pharmacol Ther","doi-asserted-by":"crossref"},{"DOI":"10.1097/MIB.0000000000001143","key":"10.1053/j.gastro.2025.09.038_bib158","year":"2017","issue":null,"author":"Fernandes","volume":"23","first-page":"1403","unstructured":null,"article-title":"Transmural healing is associated with improved long-term outcomes of patients with Crohn's disease","journal-title":"Inflamm Bowel Dis","doi-asserted-by":"crossref"},{"DOI":"10.14309/ajg.0000000000003465","key":"10.1053/j.gastro.2025.09.038_bib159","year":"2025","issue":null,"author":"Lichtenstein","volume":"120","first-page":"1225","unstructured":null,"article-title":"ACG Clinical Guideline: management of Crohn's disease in adults","journal-title":"Am J Gastroenterol","doi-asserted-by":"crossref"},{"DOI":"10.1093/ecco-jcc/jjae091","key":"10.1053/j.gastro.2025.09.038_bib160","year":"2024","issue":null,"author":"Gordon","volume":"18","first-page":"1531","unstructured":null,"article-title":"ECCO Guidelines on Therapeutics in Crohn’s Disease: medical treatment","journal-title":"J Crohns Colitis","doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,12]]}},"update-policy":"https://doi.org/10.1016/elsevier_cm_policy","alternative-id":["S0016508525060913"],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","gastrojournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Gastroenterology"],"published-print":{"date-parts":[[2025,12]]},"reference-count":159,"published-online":null,"references-count":159,"short-container-title":["Gastroenterology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1053/j.gastro.2025.09.038","is_oa":true,"title":"AGA Living Clinical Practice Guideline on the Pharmacologic Management of Moderate-to-Severe Crohn’s Disease","updated":"2025-11-23T06:18:26+00:00","published_date":"2025-11-20","best_oa_location":{"url":"https://www.gastrojournal.org/article/S0016-5085(25)06091-3/pdf","pmh_id":null,"url_for_pdf":"https://www.gastrojournal.org/article/S0016-5085(25)06091-3/pdf","url_for_landing_page":"https://doi.org/10.1053/j.gastro.2025.09.038"}}},"created_at":"2025-12-04T03:42:26.941Z","updated_at":"2025-12-08T12:24:58.509Z","tags":[{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"certolizumab pegol","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"guselkumab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"infliximab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"mirikizumab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"risankizumab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"modality","value":"Integrin Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"modality","value":"Thiopurine","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"warning","value":"As a living guideline, recommendations may change with updates.","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"warning","value":"Efficacy tiers (higher, intermediate, lower) are referenced without quantitative definition in the abstract; consult the full guideline for criteria.","value_numeric":null},{"paper_doi":"10.1053/j.gastro.2025.09.038","tag_type":"warning","value":"This is a clinical practice guideline summary, not primary trial data; effect sizes are not provided in the abstract.","value_numeric":null}],"summaries":{"what_studied":"An AGA living guideline used the GRADE framework to issue pharmacologic recommendations for adults with moderate-to-severely active Crohn’s disease.","key_result":"The panel issued 16 recommendations (1 strong, 9 conditional, 6 knowledge gaps): it recommends infliximab, adalimumab, ustekinumab, risankizumab, mirikizumab, guselkumab, or upadacitinib over no treatment, and suggests certolizumab pegol or vedolizumab over no treatment. It advises higher-efficacy agents first-line in advanced-therapy–naïve patients; after prior advanced therapy, it suggests higher-efficacy (adalimumab, risankizumab, guselkumab, upadacitinib) or intermediate-efficacy (ustekinumab, mirikizumab) over lower-efficacy (vedolizumab, certolizumab pegol); avoid thiopurine monotherapy for induction but consider it for maintenance, use subcutaneous not oral methotrexate, favor infliximab plus thiopurine over infliximab alone, and start with advanced therapy rather than step therapy with steroids/immunomodulators.","practice_takeaway":"For adult outpatients with moderate-to-severe Crohn’s disease, start with an advanced therapy and choose a higher-efficacy agent when naïve to advanced treatments; after prior exposure, avoid lower-efficacy options. Do not use thiopurines to induce remission, use subcutaneous methotrexate if chosen, and prefer infliximab plus a thiopurine over infliximab alone."}}],"initialOffset":16,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"infliximab"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"infliximab"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"infliximab"}}}]]