{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:15:22Z","timestamp":1789172122828,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In the SEQUENCE trial, risankizumab was non-inferior for clinical remission and superior for endoscopic remission compared to ustekinumab in anti-TNF-exposed Crohn\u2019s disease (CD) patients. Given unclear results in real-world settings, we aimed to evaluate whether these findings translate to real-world advanced therapy-exposed and na\u00efve CD cohorts.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study using the TriNetX database with 1:1 propensity-score matching (PSM) analyzed 2 CD cohorts (advanced therapy-exposed and na\u00efve) from inception to March 29, 2026. Primary outcomes were corticosteroid use, hospitalization, emergency department (ED) visits, intestinal surgery, intestinal complications, C-reactive protein (CRP)\u2009\u2265\u200910\u2009mg\/L, and therapy switching. Secondary outcomes included venous thromboembolism (VTE), major adverse cardiovascular events (MACE), and opportunistic infections. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with outcomes assessed at 12 and 24\u2009months.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n After PSM, each group in the advanced therapy-exposed cohort comprised 1799 patients, and each group in the advanced therapy-na\u00efve cohort comprised 1776 patients. In the advanced therapy-exposed cohort, compared with ustekinumab, the risankizumab group had a statistically significant lower odds of ED visits, intestinal fistula, CRP \u226510\u2009mg\/L, MACE, and opportunistic infections at 12\u2009months, while hospitalization (OR = 0.67, 95% CI, 0.50-0.91), ED visits (OR = 0.49, 95% CI, 0.35-0.68), overall intestinal surgery (OR = 0.68, 95% CI, 0.52-0.90), small intestine surgery (OR = 0.71, 95% CI, 0.52-0.99), large intestine surgery (OR = 0.72, 95% CI, 0.53-0.97), intestinal obstruction (OR = 0.69, 95% CI, 0.51-0.93), intestinal fistula (OR = 0.53, 95% CI, 0.36-0.78), CRP \u226510\u2009mg\/L (OR: 0.62, 95% CI, 0.46-0.85), MACE, and opportunistic infections at 24\u2009months. Similarly, in the na\u00efve cohort, compared with ustekinumab, risankizumab had a statistically significant lower odds of only CRP \u226510\u2009mg\/L at 12\u2009months, while hospitalization, ED visits, overall intestinal surgery, small intestine surgery, large intestine surgery, anal surgery, overall complication of intestines, intestinal obstruction, switching to another advanced therapy, CRP \u226510\u2009mg\/L, and opportunistic infections at 24\u2009months.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In real-world practice, risankizumab was associated with modestly more favorable outcomes in patients with prior advanced therapy exposure, whereas differences became more apparent at 24\u2009months in advanced therapy-na\u00efve patients. Prospective studies are needed to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/crocol\/otag096","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:14:41Z","timestamp":1786965281000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness and safety of risankizumab vs ustekinumab in patients with Crohn\u2019s disease: a propensity score\u2013matched multicenter retrospective cohort study"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-619X","authenticated-orcid":false,"given":"Bisher","family":"Sawaf","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Toledo , Toledo, OH,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Battistin","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Toledo , Toledo, OH,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Abu-Rumaileh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6899-238X","authenticated-orcid":false,"given":"Kyrillos Mahrous","family":"Gerges","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sohag University , Sohag,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1695-7750","authenticated-orcid":false,"given":"Yusuf","family":"Hallak","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Toledo , Toledo, OH,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6812-2192","authenticated-orcid":false,"given":"Shahem","family":"Abbarh","sequence":"additional","affiliation":[{"name":"Internal Medicine, MedStar Health Georgetown University , Baltimore, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Batikh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, John H. 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Cleveland Clinic , Cleveland, Ohio,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1641-9976","authenticated-orcid":false,"given":"Mohammad","family":"Al-Haddad","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]},{"name":"Division of Gastroenterology and Hepatology, School of Medicine, The University of Jordan , Amman,","place":["Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026091119565719000_otag096-B1","doi-asserted-by":"publisher","first-page":"2769","DOI":"10.1016\/s0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based 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