{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:08Z","timestamp":1787008688254,"version":"build-2736575974"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Risankizumab is an interleukin (IL)-23 inhibitor that is effective for the treatment of moderate-to-severe Crohn\u2019s disease (CD). However, many patients experience loss of response. Switching within the IL-23 inhibitor class to agents with more frequent dosing, such as guselkumab, may represent a salvage strategy, though no supporting data exist. We aimed to describe outcomes following switching between IL-23 antagonists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case series included five CD patients at a Canadian tertiary care center with primary non-response or secondary loss of response to risankizumab who were switched to guselkumab. Data were collected at baseline, during risankizumab therapy, and after switching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five CD patients with inadequate response to risankizumab were included. One patient (20%) had primary non-response and four (80%) had secondary loss of response. Risankizumab duration ranged from 3 to 38\u2009months (mean 17.4\u2009\u00b1\u200912.9). Four patients had active disease on baseline endoscopy before switching. Mean follow-up after switching was 3.8\u2009\u00b1\u20091.9\u2009months. Mean CD-PRO2 improved from 22.7 to 5.2 post-switching. Clinical response (\u226550% CD-PRO2 reduction) was achieved in 4\/5 patients (80%), and clinical remission (CD-PRO2\u2009&amp;lt;\u20098) was similarly achieved in 4\/5 patients (80%). Among four patients with biochemical data, biochemical response (\u226550% reduction in fecal calprotectin [FCal]) and remission (normalization of FCal) each occurred in 75%, with a mean FCal reduction of 618\u2009\u00b5g\/g. One patient had biochemical worsening despite clinical improvement. No safety concerns were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In CD patients with loss of response to risankizumab, switching to guselkumab may be effective in selected patients. Larger confirmatory studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag089","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T11:39:32Z","timestamp":1780745972000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes following switch from risankizumab to guselkumab in Crohn\u2019s disease: a real-world case series"],"prefix":"10.1093","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3077-2958","authenticated-orcid":false,"given":"Amar","family":"Farkouh","sequence":"first","affiliation":[{"name":"Centre Hospitalier de l\u2018Universit\u00e9 de Montr\u00e9al (CHUM), CHUM Research Center (CRCHUM), University of Montreal , Montreal,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil","family":"Nathoo-Khedri","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2018Universit\u00e9 de Montr\u00e9al (CHUM), CHUM Research Center (CRCHUM), University of Montreal , Montreal,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Dufresne","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Montreal , Montreal,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Homa","family":"Danaie","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Montreal , Montreal,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7421-9764","authenticated-orcid":false,"given":"Robert","family":"Battat","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2018Universit\u00e9 de Montr\u00e9al (CHUM), CHUM Research Center (CRCHUM), University of Montreal , Montreal,","place":["Canada"]},{"name":"Division of Gastroenterology, Centre Hospitalier de l\u2018Universit\u00e9 de Montr\u00e9al (CHUM) , Montreal,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"2026062600535044800_jjag089-B1","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1016\/S0140-6736(22)00467-6","article-title":"Risankizumab as induction therapy for Crohn\u2019s disease: results from the phase 3 ADVANCE and MOTIVATE induction trials","volume":"399","author":"D\u2019Haens","year":"2022","journal-title":"Lancet"},{"key":"2026062600535044800_jjag089-B2","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1016\/S0140-6736(22)00466-4","article-title":"Risankizumab as maintenance therapy for moderately to severely active Crohn\u2019s disease: results from the multicentre, randomised, double-blind, placebo-controlled, withdrawal phase 3 FORTIFY maintenance trial","volume":"399","author":"Ferrante","year":"2022","journal-title":"Lancet"},{"key":"2026062600535044800_jjag089-B3","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1001\/jama.2024.12414","article-title":"Risankizumab for ulcerative colitis: two randomized clinical trials","volume":"332","author":"Louis","year":"2024","journal-title":"JAMA"},{"key":"2026062600535044800_jjag089-B4","doi-asserted-by":"publisher","first-page":"2444","DOI":"10.1056\/NEJMoa2207940","article-title":"Mirikizumab as induction and maintenance therapy for ulcerative colitis","volume":"388","author":"D\u2019Haens","year":"2023","journal-title":"N Engl J Med"},{"key":"2026062600535044800_jjag089-B5","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/S0140-6736(25)00681-6","article-title":"Efficacy and safety of intravenous induction and subcutaneous maintenance therapy with guselkumab for patients with Crohn\u2019s disease (GALAXI-2 and GALAXI-3): 48-week results from two phase 3, randomised, placebo and active comparator-controlled, double-blind, triple-dummy trials","volume":"406","author":"Panaccione","year":"2025","journal-title":"Lancet"},{"key":"2026062600535044800_jjag089-B6","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1016\/S2468-1253(21)00312-5","article-title":"Comparative efficacy and safety of biologic therapies for moderate-to-severe Crohn\u2019s disease: a systematic review and network meta-analysis","volume":"6","author":"Singh","year":"2021","journal-title":"Lancet Gas\u00adtroenterol Hepatol"},{"key":"2026062600535044800_jjag089-B7","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1111\/apt.13083","article-title":"Systematic review with meta-analysis: the efficacy of a second anti-TNF in patients with inflammatory bowel disease whose previous anti-TNF treatment has failed","volume":"41","author":"Gisbert","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"key":"2026062600535044800_jjag089-B8","doi-asserted-by":"publisher","first-page":"e278","DOI":"10.1111\/jdv.70197","article-title":"Switching within the class of IL-23 inhibitors for the treatment of psoriasis: a systematic review","volume":"40","author":"Koumprentziotis","year":"2026","journal-title":"J Eur Acad Dermatol Venereol"}],"container-title":["Journal of Crohn's and 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