{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T01:24:43Z","timestamp":1770254683108,"version":"3.49.0"},"reference-count":127,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Demyelinating diseases, particularly multiple sclerosis (MS), present a unique therapeutic challenge in the management of inflammatory bowel disease (IBD). Although rare, the co-occurrence of IBD and demyelinating disorders is well-documented and may reflect shared immune, genetic, and environmental risk factors. As the therapeutic landscape of IBD expands to include biologics and small molecules that target immune pathways also implicated in MS, concerns around neurological safety have grown. In particular, anti-tumor necrosis factor agents have been consistently linked to new-onset or worsening demyelinating events, while other treatments such as sphingosine-1-phosphate receptor modulators and natali\u00adzumab are licensed for both IBD and MS, though real-world data in patients with coexisting disease remain limited. This review synthesizes current evidence regarding the neurological safety and efficacy of IBD therapies in the context of demyelinating disease. It proposes a practical framework for clinicians, addressing management strategies for patients with confirmed MS, those at increased risk, and individuals who develop neurological symptoms during treatment. In the absence of formal guidelines, multidisciplinary collaboration, early recognition of symptoms, and careful treatment selection are important to optimize both gastrointestinal and neurological outcomes.<\/jats:p>","DOI":"10.1093\/ecco-jcc\/jjaf215","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T13:09:43Z","timestamp":1764335383000},"source":"Crossref","is-referenced-by-count":0,"title":["Inflammatory bowel disease therapies and demyelinating diseases: a practical guide to therapeutic benefit and risk"],"prefix":"10.1093","volume":"20","author":[{"given":"Sailish","family":"Honap","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, St George\u2019s University Hospitals NHS Foundation Trust , London,","place":["United Kingdom"]},{"name":"School of Immunology and Microbial Sciences, King\u2019s College London , London,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Debouverie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nancy University Hospital , Nancy, F-54 000,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-0479","authenticated-orcid":false,"given":"Massimo","family":"Filippi","sequence":"additional","affiliation":[{"name":"Neurology Unit, Multiple Sclerosis Centre, IRCCS San Raffaele Scientific Institute , Milan, 20132,","place":["Italy"]},{"name":"Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute , Milan,","place":["Italy"]},{"name":"Vita-Salute San Raffaele University , Milan,","place":["Italy"]},{"name":"Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute , Milan,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Selchen","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, St Michael\u2019s Hospital , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-0033","authenticated-orcid":false,"given":"Vipul","family":"Jairath","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Western University , London, Ontario,","place":["Canada"]},{"name":"Department of Epidemiology and Biostatistics, Western University , London, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-1351","authenticated-orcid":false,"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele , Milan,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Peyrin-Biroulet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Universit\u00e9 de Lorraine , Vand\u0153uvre-l\u00e8s-Nancy, F-54500,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"2026020320120208900_jjaf215-B1","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0140-6736(23)00966-2","article-title":"Ulcerative Colitis","volume":"402","author":"Berre","year":"2023","journal-title":"The Lancet"},{"key":"2026020320120208900_jjaf215-B2","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/S0140-6736(23)02586-2","article-title":"Crohn\u2019s disease","volume":"403","author":"Dolinger","year":"2024","journal-title":"The 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