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:T4ab,The study included 4438 unique patients with psoriasis (2717 [61.2%] male; mean [SD] age, 45.0 [14.6] years at the time of their first treatment included in the study), 1039 (23.4%) of whom had comorbid psoriatic arthritis. A total of 3790 treatment series from bionaive patients were analyzed: 2646 were with adalimumab, 377 with secukinumab, and 767 with ustekinumab. The 5-year standardized risk of discontinuing ustekinumab was 0.37 (95% CI, 0.33-0.41), which was significantly lower than the standardized risks for adalimumab (0.51; 95% CI, 0.49-0.54) and secukinumab (0.54; 95% CI, 0.48-0.60). A total of 3403 treatment series from bioexperienced patients were analyzed: 790 were with adalimumab, 376 with bimekizumab, 192 with brodalumab, 218 with guselkumab, 556 with ixekizumab, 78 with risankizumab, 466 with secukinumab, and 727 with ustekinumab. The 2-year standardized absolute risk of discontinuing ustekinumab was 0.39 (95% CI, 0.36-0.43). Only bimekizumab (0.27; 95% CI, 0.20-0.34), guselkumab (0.29; 95% CI, 0.22-0.36), and risankizumab (0.25; 95% CI, 0.15-0.36) were associated with a significantly lower standardized absolute risk of discontinuation compared with ustekinumab.31:Taf0,Drug survival is an important measure to help guide treatment selection. However, clinical evidence for newer biologics, including bimekizumab, is limited. To determine the drug survival of biologics used for treating psoriasis in a routine clinical practice setting. This cohort study was based on data from the DERMBIO registry, which includes all patients treated with biologics for psoriasis in Denmark. All adult patients enrolled in DERMBIO from its inception in May 2007 until June 2025 were assessed for eligibility. Data were extracted in June 2025 and analyzed separately among those without previous biologic exposure (bionaive patients) and those with previous biologic exposure (bioexperienced patients). Adalimumab, secukinumab, and ustekinumab among bionaive patients and adalimumab, bimekizumab, brodalumab, guselkumab, ixekizumab, risankizumab, secukinumab, and ustekinumab among bioexperienced patients. The main outcome was standardized absolute risks of treatment discontinuation at 1, 2, and 5 years. Kaplan-Meier estimator was used to determine crude drug survival estimates and the Aalen-Johansen estimator was used to determine crude cause-specific absolute risks. The study included 4438 unique patients with psoriasis (2717 [61.2%] male; mean [SD] age, 45.0 [14.6] years at the time of their first treatment included in the study), 1039 (23.4%) of whom had comorbid psoriatic arthritis. A total of 3790 treatment series from bionaive patients were analyzed: 2646 were with adalimumab, 377 with secukinumab, and 767 with ustekinumab. The 5-year standardized risk of discontinuing ustekinumab was 0.37 (95% CI, 0.33-0.41), which was significantly lower than the standardized risks for adalimumab (0.51; 95% CI, 0.49-0.54) and secukinumab (0.54; 95% CI, 0.48-0.60). A total of 3403 treatment series from bioexperienced patients were analyzed: 790 were with adalimumab, 376 with bimekizumab, 192 with brodalumab, 218 with guselkumab, 556 with ixekizumab, 78 with risankizumab, 466 with secukinumab, and 727 with ustekinumab. The 2-year standardized absolute risk of discontinuing ustekinumab was 0.39 (95% CI, 0.36-0.43). Only bimekizumab (0.27; 95% CI, 0.20-0.34), guselkumab (0.29; 95% CI, 0.22-0.36), and risankizumab (0.25; 95% CI, 0.15-0.36) were associated with a significantly lower standardized absolute risk of discontinuation compared with ustekinumab. In this cohort study in Denmark, among bionaive patients with psoriasis, ustekinumab had superior drug survival compared with adalimumab and secukinumab, and among bioexperienced patients with psoriasis, bimekizumab, guselkumab, and risankizumab had superior drug survival. These results offer insight into the performance of different biologics in the treatment of psoriasis in a routine clinical practice setting.32:Tfc4, Importance Drug survival is an important measure to help guide treatment selection. However, clinical evidence for newer biologics, including bimekizumab, is limited. Objective To determine the drug survival of biologics used for treating psoriasis in a routine clinical practice setting. Design, Setting, and Participants This cohort study was based on data from the DERMBIO registry, which includes all patients treated with biologics for psoriasis in Denmark. All adult patients enrolled in DERMBIO from its inception in May 2007 until June 2025 were assessed for eligibility. Data were extracted in June 2025 and analyzed separately among those without previous biologic exposure (bionaive patients) and those with previous biologic exposure (bioexperienced patients). Exposures Adalimumab, secukinumab, and ustekinumab among bionaive patients and adalimumab, bimekizumab, brodalumab, guselkumab, ixekizumab, risankizumab, secukinumab, and ustekinumab among bioexperienced patients. Main Outcomes and Measures The main outcome was standardized absolute risks of treatment discontinuation at 1, 2, and 5 years. Kaplan-Meier estimator was used to determine crude drug survival estimates and the Aalen-Johansen estimator was used to determine crude cause-specific absolute risks. Results The study included 4438 unique patients with psoriasis (2717 [61.2%] male; mean [SD] age, 45.0 [14.6] years at the time of their first treatment included in the study), 1039 (23.4%) of whom had comorbid psoriatic arthritis. A total of 3790 treatment series from bionaive patients were analyzed: 2646 were with adalimumab, 377 with secukinumab, and 767 with ustekinumab. The 5-year standardized risk of discontinuing ustekinumab was 0.37 (95% CI, 0.33-0.41), which was significantly lower than the standardized risks for adalimumab (0.51; 95% CI, 0.49-0.54) and secukinumab (0.54; 95% CI, 0.48-0.60). A total of 3403 treatment series from bioexperienced patients were analyzed: 790 were with adalimumab, 376 with bimekizumab, 192 with brodalumab, 218 with guselkumab, 556 with ixekizumab, 78 with risankizumab, 466 with secukinumab, and 727 with ustekinumab. The 2-year standardized absolute risk of discontinuing ustekinumab was 0.39 (95% CI, 0.36-0.43). Only bimekizumab (0.27; 95% CI, 0.20-0.34), guselkumab (0.29; 95% CI, 0.22-0.36), and risankizumab (0.25; 95% CI, 0.15-0.36) were associated with a significantly lower standardized absolute risk of discontinuation compared with ustekinumab. Conclusions and Relevance In this cohort study in Denmark, among bionaive patients with psoriasis, ustekinumab had superior drug survival compared with adalimumab and secukinumab, and among bioexperienced patients with psoriasis, bimekizumab, guselkumab, and risankizumab had superior drug survival. These results offer insight into the performance of different biologics in the treatment of psoriasis in a routine clinical practice setting. 33: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.34: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\":\"ustekinumab: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on ustekinumab (generic). Clinician-written summaries and actionable practice insights. 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no meta-analysis was conducted due to methodological heterogeneity.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0797","tag_type":"warning","value":"Sex tag set to 'female' as the primary dataset covers maternal exposure; paternal exposure studies also exist but are a small subset (3 studies, 281 pregnancies).","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0797","tag_type":"warning","value":"The review included all indications for IL inhibitors (not psoriasis-only), so findings may not be fully generalizable to psoriasis patients specifically.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0797","tag_type":"warning","value":"The sample size (n=5,962) reflects maternal pregnancy exposures across all included studies, not a single trial cohort; the majority originated from pharmacovigilance databases with inherent reporting bias.","value_numeric":null}],"summaries":{"what_studied":"A PRISMA-compliant systematic literature review (search date May 2026) evaluated the reproductive safety of IL-12/23, IL-17, and IL-23 inhibitors during pregnancy and with paternal exposure in patients with psoriasis, examining pregnancy and neonatal outcomes across all available study designs.","key_result":"49 publications met inclusion criteria, reporting 5,962 pregnancies with maternal exposure; ustekinumab had the most data (2,933 pregnancies), followed by secukinumab (1,877), risankizumab (589), ixekizumab (296), guselkumab (217), tildrakizumab (32), bimekizumab (11), brodalumab (6), and mirikizumab (1). Cohort-level findings were generally reassuring — no consistent signal for adverse pregnancy or neonatal outcomes — except one study reporting increased risk of small-for-gestational-age infants with ustekinumab. Paternal exposure data were very limited (3 studies, 281 pregnancies).","limitations":"- Most exposures (n=5,074) came from pharmacovigilance databases that capture only adverse events, making incidence rates incalculable and meta-analysis infeasible.\n- Critical confounders (disease activity, exposure timing, comedications) were missing or unreported in the majority of studies; only one study used confounder-adjusted analysis.\n- Data were heavily skewed toward IBD patients, limiting psoriasis-specific and IL-17-specific conclusions.","practice_takeaway":"Available data are broadly reassuring but insufficient to issue definitive safety guidance; clinicians should weigh uncontrolled disease risk against medication uncertainty on a case-by-case basis. Existing psoriasis registries (e.g., BADBIR, BioCAPTURE) should add standardized pregnancy datasets to accelerate evidence generation."}},{"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":"10.1016/j.cgh.2026.08.014","pmid":"42660257","title":"Clinical Outcomes After Ustekinumab Biosimilar Switching in Crohn’s Disease: the USBIOS IG-IBD Study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-08-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.08.014","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-01T06:21:08.279Z","updated_at":"2026-09-01T06:21:08.279Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"sample_size","value":"n=462","value_numeric":462},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"study_design","value":"Prospective Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"warning","value":"Brand names of the 3 specific biosimilars used are not listed in the abstract; brand/generic tags for individual biosimilars could not be added.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"warning","value":"Every-4-week dosing subgroup is very small (n=4, 0.9%), limiting any subgroup inference for that population.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.014","tag_type":"warning","value":"The control group (n=125) was not randomly assigned; procurement-driven allocation may introduce unmeasured confounding despite propensity-score adjustment.","value_numeric":null}],"summaries":{"what_studied":"This prospective observational cohort study at 18 Italian centers compared 6-month clinical outcomes in adults with Crohn's disease (CD) in stable remission who underwent a procurement-driven nonmedical switch from reference ustekinumab to one of 3 approved biosimilars (n=337) versus those who continued reference treatment (n=125).","key_result":"Expanded clinical success (remission, steroid-free, no biologic discontinuation, no IBD hospitalization or surgery) was achieved in 92.2% of switchers vs. 92.7% of controls (risk difference −0.5%, 95% CI −5.9 to 4.9), meeting the prespecified noninferiority margin of −15%. Biosimilar persistence was 93.7%; switch-back rate was 1.2%; only 2 adverse events were reported after switching.","limitations":"- Observational design with unequal group sizes (337 vs. 125) and potential selection bias, despite propensity-score weighting.\n- Only 4 patients (0.9%) were on every-4-week dosing, so results may not generalize to this higher-intensity subgroup.\n- Follow-up was limited to 6 months; longer-term durability of biosimilar switching remains unknown.","practice_takeaway":"For clinically stable CD patients on reference ustekinumab, a nonmedical switch to an approved biosimilar appears safe and effective over 6 months, with outcomes virtually identical to staying on the reference product. Clinicians can proceed with procurement-driven switches in this population but should monitor patients on every-4-week dosing more closely, as evidence is very limited for that group."}},{"doi":"10.14309/ajg.0000000000004119","pmid":"42467952","title":"Absolute Risk of Malignancy by Treatment in Patients With Crohn's Disease Compared with the General Population: A Nationwide Population-Based Cohort Study","journal_title":"American Journal of Gastroenterology","journal_issn":"0002-9270","published_at":"2026-08-26T00:00:00.000Z","url":"https://doi.org/10.14309/ajg.0000000000004119","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-28T06:25:32.491Z","updated_at":"2026-08-28T06:25:32.491Z","tags":[{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"condition","value":"Malignancy","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"condition","value":"Nonmelanoma Skin Cancer","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"modality","value":"Integrin Inhibitor","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"modality","value":"Thiopurine","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"sample_size","value":"n=38733","value_numeric":38733},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"warning","value":"Comparator group (n=360,616) is substantially larger than the patient cohort; matching details and ratio are not fully described in the abstract.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"warning","value":"Impact flag 'practice_changing' applied cautiously — findings reinforce skin cancer surveillance across all CD patients and may influence biologic selection, but vedolizumab/ustekinumab results are underpowered.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"warning","value":"The 'once-exposed-always-exposed' design means patients are kept in a treatment cohort regardless of stopping or switching therapy, which may overestimate or distort treatment-specific cancer risk.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004119","tag_type":"warning","value":"The thiopurine generic tag uses azathioprine as a representative agent; the paper refers broadly to thiopurines, which may also include mercaptopurine or thioguanine.","value_numeric":null}],"summaries":{"what_studied":"This nationwide Swedish register-based cohort study assessed absolute cancer risk in 38,733 patients with Crohn's disease (CD) across six treatment cohorts (thiopurine, TNFi, thiopurine+TNFi, vedolizumab, ustekinumab, and immunomodulator-naïve) versus 360,616 matched general-population comparators, followed for a median of 7.3 years (2007–2023).","key_result":"Excess cancer incidence (vs. general population) ranged from 1.54 to 3.14 per 1,000 person-years across all treatment groups, including naïve patients (2.43; 95% CI 1.92–2.94); nonmelanoma skin cancer drove most of the excess. After excluding nonmelanoma skin cancers, excess incidence fell to ~1 extra case per 1,000 person-years in naïve, thiopurine, and TNFi cohorts (driven by lung, small bowel, hepatobiliary, and hematologic cancers), and was not significantly elevated in vedolizumab or ustekinumab groups.","limitations":"- Once-exposed-always-exposed design may not capture treatment duration or switching effects accurately.\n- Residual confounding by disease severity and indication bias cannot be excluded, as sicker patients are more likely to receive immunomodulators.\n- Ustekinumab and vedolizumab cohorts had wide confidence intervals, suggesting limited statistical power for those groups.","practice_takeaway":"All CD patients—even those on no immunomodulatory therapy—carry a modestly elevated cancer risk vs. the general population, largely from nonmelanoma skin cancer; counsel patients across all treatment lines about skin surveillance. After excluding skin cancers, vedolizumab and ustekinumab users did not show a statistically significant excess cancer risk, which may be reassuring when choosing therapy for higher-risk patients."}},{"doi":"10.1016/j.cgh.2026.07.020","pmid":"42562116","title":"Superior Effectiveness of Upadacitinib Over Tofacitinib and Ustekinumab in Bio-Exposed Ulcerative Colitis: The TRIDENT-UC Study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-08-07T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.07.020","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-14T13:24:53.592Z","updated_at":"2026-08-14T13:24:53.592Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"sample_size","value":"n=312","value_numeric":312},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"The mean age at diagnosis (32.6 years) is reported, but the age range of enrolled patients is not provided, limiting age-group precision beyond 'adult'.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — this is a retrospective observational study with IPTW adjustment, not a head-to-head RCT; residual confounding cannot be excluded.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"Tofacitinib subgroup (n=74) is notably smaller than ustekinumab (n=135) and upadacitinib (n=103), which may affect the stability of IPTW-weighted estimates for that arm.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"Ustekinumab is not FDA-approved specifically for UC in the same manner as for Crohn's disease; its use in this context may reflect off-label or region-specific prescribing practices.","value_numeric":null}],"summaries":{"what_studied":"Retrospective multicenter study (9 centers, n=312) comparing upadacitinib, tofacitinib, and ustekinumab in bio-exposed UC patients who had failed ≥1 advanced therapy, assessed at weeks 16 and 52 for steroid-free clinical remission (SFCR) and endoscopic remission.","key_result":"After propensity score-weighted analysis, upadacitinib had higher SFCR odds vs. tofacitinib (w16: OR 2.56; w52: OR 3.14) and ustekinumab (w16: OR 3.71; w52: OR 4.68). Endoscopic remission rates at w52 were 56.8% (upadacitinib) vs. 32.7% (tofacitinib) vs. 22.5% (ustekinumab), with upadacitinib outperforming both at both timepoints.","limitations":"Retrospective design with inherent selection bias; IPTW mitigates but does not eliminate confounding; single-country or limited-center generalizability not specified, and small subgroup sizes (tofacitinib n=74) may limit precision of estimates.","practice_takeaway":"In UC patients who have failed a prior biologic, upadacitinib achieves meaningfully higher rates of steroid-free clinical and endoscopic remission than either tofacitinib or ustekinumab at both 16 and 52 weeks. Clinicians should prioritize upadacitinib when selecting a second-line advanced therapy in this population."}},{"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/ibd/izag142","pmid":"42520305","title":"Risk of serious infection, myocardial infarction, stroke, and thromboembolic events in patients in the United States with ulcerative colitis treated with tofacitinib compared with biologic treatments","journal_title":"Inflammatory Bowel Diseases","journal_issn":"1078-0998","published_at":"2026-07-28T00:00:00.000Z","url":"https://doi.org/10.1093/ibd/izag142","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:01.291Z","updated_at":"2026-08-04T18:18:01.291Z","tags":[{"paper_doi":"10.1093/ibd/izag142","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"Integrin Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"sample_size","value":"n=62596","value_numeric":62596},{"paper_doi":"10.1093/ibd/izag142","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"warning","value":"Sample size is the sum of all four treatment groups (5171 + 10424 + 17129 + 29872 = 62596); individual group Ns vary considerably, which may affect power for rare outcomes like MI/stroke.","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"warning","value":"TNF inhibitor brand names were not individually specified in the abstract; no brand tags were added for this class.","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"warning","value":"Tofacitinib initiators were markedly more biologic-experienced than biologic initiators at baseline; sIPTW adjustment was applied but residual confounding by indication is likely. Interpret hazard ratios with caution.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used US claims data (Komodo Health) to compare risks of serious infection, MI, stroke, and VTE among UC patients initiating tofacitinib, ustekinumab, vedolizumab, or TNF inhibitors between May 2018 and September 2022, with a mean follow-up of ~359 days.","key_result":"No significant risk differences were found between tofacitinib and any biologic. Serious infection IRs/100 PY were 2.62 (tofacitinib), 2.73 (ustekinumab), 2.45 (vedolizumab), and 3.25 (TNFi). MI/stroke IRs/100 PY were 0.13, 0.17, 0.17, and 0.19; VTE IRs/100 PY were 0.17, 0.16, 0.23, and 0.33, respectively.","limitations":"- Tofacitinib initiators were more biologic-experienced at baseline (46.3% had ≥2 prior biologics vs 7.5%–33.7% for biologics), indicating channeling bias that sIPTW adjustment may not fully correct.\n- Mean follow-up of ~359 days may miss long-term safety signals.\n- Claims data cannot capture unmeasured confounders (e.g., disease severity, smoking status).","practice_takeaway":"In a large US real-world population with UC, tofacitinib showed no significantly higher risk of serious infection, MI, stroke, or VTE compared with ustekinumab, vedolizumab, or TNF inhibitors. Clinicians can factor these data into shared decision-making, particularly for biologic-experienced patients weighing tofacitinib."}},{"doi":"10.1136/rmdopen-2025-006577","pmid":"42457215","title":"Psoriatic arthritis and obesity: a review of clinical burden and considerations for comprehensive care","journal_title":"RMD Open","journal_issn":"2056-5933","published_at":"2026-07-15T00:00:00.000Z","url":"https://doi.org/10.1136/rmdopen-2025-006577","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:36:05.406Z","updated_at":"2026-07-20T13:36:05.406Z","tags":[{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Cosentyx","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Mounjaro","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Ozempic","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Taltz","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Wegovy","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"brand","value":"Zepbound","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Metabolic Syndrome","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Psoriasis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"bimekizumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"ixekizumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"secukinumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"tirzepatide","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"GIP/GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"IL-17 Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"sample_size","value":"n=49","value_numeric":49},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"Sample size tag reflects the number of included studies in the narrative review, not a patient-level N.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the TOGETHER-PsA combination therapy signal and the emerging incretin data; clinicians should note that PsA-specific regulatory approvals for GLP-1/GIP RAs are not yet established.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"The TOGETHER-PsA trial (n=271) results cited are from a 2026 publication; full peer-reviewed data should be independently verified as the review appears to have had early access.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006577","tag_type":"warning","value":"This review was funded by Eli Lilly and Company, and three co-authors are Lilly employees; tirzepatide (a Lilly product) is featured prominently including data from the TOGETHER-PsA trial authored by overlapping investigators.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examined the interplay between psoriatic arthritis (PsA) and obesity, covering shared inflammatory pathways, impact on disease severity and treatment response, weight-management strategies (lifestyle, bariatric surgery, pharmacological), and the potential role of incretin-based therapies (GLP-1 RAs, dual GIP/GLP-1 RAs). Literature search covered PubMed, Embase, and Scopus up to October 2025; 49 studies were included.","key_result":"Obesity (BMI ≥30) worsens PsA severity, reduces biologic response, and raises cardiovascular risk. Key data points: each 1-unit BMI rise in psoriasis patients increases PsA risk by 5.3%; modest weight loss (5–10% body weight) improves disease activity; in one trial, ACR20 response was 71% vs 30% (p=0.008) in patients who lost ≥18.6% weight. The TOGETHER-PsA trial (n=271) found ixekizumab plus tirzepatide achieved ACR50 and ≥10% weight loss at week 36 in 31.7% vs 0.8% with ixekizumab alone (p<0.001), with higher ACR50 rates (33.5% vs 20.4%; p=0.02).","limitations":"- Non-systematic search introduces selection bias despite efforts to prioritize higher-quality evidence.\n- Three authors are Eli Lilly employees and the study was funded by Eli Lilly, raising potential conflict of interest given tirzepatide (Mounjaro/Zepbound) is a Lilly product prominently featured.\n- PsA-specific outcome data for incretin-based therapies remain limited; most cardiovascular and weight-loss data derive from diabetes or general obesity populations.","practice_takeaway":"Treat obesity as a core comorbidity in PsA—screen BMI routinely, integrate weight-management counseling into every rheumatology visit, and consider GLP-1 RA or GIP/GLP-1 RA co-therapy for patients with PsA and obesity who have inadequate response to biologics alone. Multidisciplinary coordination with endocrinology, dietetics, and primary care is recommended by EULAR, GRAPPA, and ACR/NPF guidelines."}},{"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.cgh.2026.06.003","pmid":"42269996","title":"Risk of lymphoma associated with biologics and immunosuppressants in inflammatory bowel disease patients: a nationwide nested case-control study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-06-11T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.06.003","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:46.577Z","updated_at":"2026-06-17T13:29:46.577Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"condition","value":"Inflammatory Bowel Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"condition","value":"Lymphoma","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"modality","value":"Integrin Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"modality","value":"Thiopurine","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"sample_size","value":"n=422793","value_numeric":422793},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"study_design","value":"Nested Case-Control Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"warning","value":"Crohn's disease and ulcerative colitis are not explicitly broken out as separate conditions in the abstract; they are inferred as the IBD subtypes studied.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"warning","value":"JAK inhibitor exposure details (specific agents, duration) are not described in the abstract, limiting interpretation of the null finding for that class.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"warning","value":"Methotrexate's lymphoma association was flagged as inconsistent across sensitivity analyses — tag for this drug should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.06.003","tag_type":"warning","value":"The paper's DOI and publication date (June 11, 2026) are in the future relative to standard indexing; content appears to be an advance publication — conclusions should be treated as preliminary until final peer-reviewed version is confirmed.","value_numeric":null}],"summaries":{"what_studied":"This nationwide nested case-control study evaluated lymphoma risk associated with IBD treatments — thiopurines, methotrexate, anti-TNF agents, vedolizumab, ustekinumab, and JAK inhibitors — in 422,793 IBD patients from the French National Health Data System (SNDS) between 2009 and 2024, with 1,238 lymphoma cases matched to 52,565 controls.","key_result":"Current thiopurine use nearly doubled lymphoma risk (aOR 2.36, 95% CI 2.00–2.79) and anti-TNF use raised it by 72% (aOR 1.72, 95% CI 1.45–2.05); their combination more than tripled risk (aOR 3.44, 95% CI 2.62–4.51). Vedolizumab, ustekinumab, and JAK inhibitors showed no increased lymphoma risk.","limitations":"Methotrexate's association with lymphoma was inconsistent across sensitivity analyses, limiting firm conclusions. As a claims-based study, residual confounding by disease severity or unmeasured factors cannot be excluded. Exposure to newer agents (vedolizumab, ustekinumab, JAKi) may be underrepresented, limiting power for those comparisons.","practice_takeaway":"When choosing maintenance therapy for IBD, clinicians should weigh the clear lymphoma risk of thiopurines and anti-TNF — especially in combination — against the reassuring safety profile of vedolizumab, ustekinumab, and JAK inhibitors. Elevated risk from thiopurines may persist up to 3 years after stopping, so post-discontinuation vigilance is warranted."}},{"doi":"10.1111/apt.70783","pmid":"42267647","title":"Real‐World Effectiveness of Risankizumab in Refractory Crohn's Disease: The RISANCROHN Study From the ENEIDA Registry","journal_title":"Alimentary Pharmacology & Therapeutics","journal_issn":"0269-2813","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1111/apt.70783","source_score":17,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-18T13:24:25.077Z","updated_at":"2026-06-18T13:24:25.077Z","tags":[{"paper_doi":"10.1111/apt.70783","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"brand","value":"Skyrizi","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"generic","value":"risankizumab","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"modality","value":"IL-23 Inhibitor","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"sample_size","value":"n=857","value_numeric":857},{"paper_doi":"10.1111/apt.70783","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"study_design","value":"Multicentre Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"warning","value":"Follow-up is short (mean 7.4 months); remission rates may not reflect sustained long-term outcomes.","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"warning","value":"Prior ustekinumab exposure showed lower remission in unadjusted but not adjusted analyses — confounding by indication is possible and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"warning","value":"Remission was defined clinically (HBI ≤4); no endoscopic, histologic, or biomarker endpoints were reported, which may overestimate true deep remission rates.","value_numeric":null},{"paper_doi":"10.1111/apt.70783","tag_type":"warning","value":"Sex distribution of the cohort is not reported in the abstract; the 'mixed' sex tag is assumed from the general adult population context.","value_numeric":null}],"summaries":{"what_studied":"Real-world effectiveness and safety of risankizumab in 857 adult patients with predominantly refractory Crohn's disease registered in the ENEIDA registry, assessing steroid-free clinical remission (Harvey-Bradshaw Index ≤4, no systemic corticosteroids) at weeks 8–12 and at last follow-up (mean 7.4 months).","key_result":"Steroid-free clinical remission was achieved in 56% at weeks 8–12 and 61% at last follow-up; patients with ≤2 prior biologics had significantly higher remission rates than those with >2 (p<0.001); treatment-related adverse events occurred in 8%, with no serious adverse events.","limitations":"Observational design limits causal inference; short mean follow-up of 7.4 months precludes long-term durability conclusions; lack of endoscopic or biomarker remission data as outcomes.","practice_takeaway":"Risankizumab provides clinically meaningful remission even in highly biologic-refractory Crohn's disease, but earlier use (≤2 prior biologics) yields better outcomes — consider positioning it before exhausting the biologic pipeline. Its favorable safety profile supports use in this complex population."}},{"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":"10.1016/j.cgh.2026.04.015","pmid":"42055304","title":"Serious infection in inflammatory bowel diseases patients treated with vedolizumab, ustekinumab, JAK inhibitors, anti-TNF or aminosalicylates","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.04.015","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:18.216Z","updated_at":"2026-05-09T13:22:18.216Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"condition","value":"Crohn's Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"condition","value":"Inflammatory Bowel Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"condition","value":"Serious Infection","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"modality","value":"Aminosalicylate","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"modality","value":"Anti-TNF Agent","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"modality","value":"Integrin Receptor Antagonist","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"sample_size","value":"n=219229","value_numeric":219229},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"warning","value":"JAKi group is substantially smaller (n=6,439) compared to anti-TNF (n=93,444), which may affect precision of estimates.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"warning","value":"Median follow-up of 1.0 year is short; long-term infection risk rankings may differ.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"warning","value":"The study is not yet formally published as of today's date (published 2026-04-27) and the DOI suggests in-press status; findings should be interpreted with that in mind.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.04.015","tag_type":"warning","value":"Vedolizumab showing higher serious infection risk than anti-TNF (aHR 1.07 vs. aminosalicylates 1.38 vs. 1.29) is counterintuitive given its gut-selective mechanism; residual confounding or channeling bias (more complex patients receiving vedolizumab) may explain this finding.","value_numeric":null}],"summaries":{"what_studied":"Nationwide French cohort of 219,229 IBD patients (>15 years) initiating vedolizumab, ustekinumab, JAK inhibitors (JAKi), anti-TNF, or aminosalicylates between 2014–2024, assessed for serious infection risk using propensity score–weighted analysis over a median follow-up of 1.0 year.","key_result":"15,081 serious infections occurred. Versus aminosalicylates: JAKi carried the highest risk (aHR 1.63, 95%CI 1.45–1.84), followed by vedolizumab (aHR 1.38), anti-TNF (aHR 1.29), and ustekinumab (aHR 1.05, essentially no excess risk). Versus anti-TNF: ustekinumab was safest (aHR 0.81), vedolizumab was similar (aHR 1.07), and JAKi was highest (aHR 1.27). Concomitant corticosteroids nearly doubled risk (aHR 2.06).","limitations":"Median follow-up of only 1.0 year limits long-term risk assessment. Residual confounding is possible despite propensity score weighting, as channel bias (sicker patients routed to specific therapies) may persist. Administrative claims data may miss nuanced clinical details (e.g., disease severity, comorbidities).","practice_takeaway":"When choosing advanced IBD therapy, ustekinumab carries the lowest serious infection risk, while JAKi carries the highest — especially for herpesvirus infections; ensure vaccination and minimize concomitant corticosteroids where possible. 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discontinuation risk was 0.37 (95% CI, 0.33-0.41) for ustekinumab vs 0.51 (0.49-0.54) for adalimumab and 0.54 (0.48-0.60) for secukinumab. Bioexperienced: 2-year risk was 0.39 (0.36-0.43) for ustekinumab and lower for bimekizumab 0.27 (0.20-0.34), guselkumab 0.29 (0.22-0.36), and risankizumab 0.25 (0.15-0.36).","limitations":"Bionaive analyses included only adalimumab, secukinumab, and ustekinumab, limiting class-wide comparisons. Some bioexperienced drugs had small sample sizes (e.g., risankizumab n=78), and follow-up windows differed (5-year bionaive vs 2-year bioexperienced), complicating cross-cohort comparisons.","practice_takeaway":"In routine practice, ustekinumab showed better 5-year persistence than adalimumab and secukinumab in bionaive patients; among bioexperienced patients, bimekizumab, guselkumab, and risankizumab had lower 2-year discontinuation risks than ustekinumab. 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