{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:43:39Z","timestamp":1789105419562,"version":"build-2803163510"},"reference-count":23,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"abstract":"<jats:p>Introduction: Risankizumab (RZB), an IL-23p19 monoclonal antibody, has demonstrated clinical efficacy in Crohn\u2019s disease (CD), yet evidence regarding its effectiveness for deep small-intestinal lesions remains scarce. These lesions are often underdiagnosed due to limited accessibility and subtle clinical presentation. Methods: We retrospectively analyzed 32 patients with moderate-to-severe CD who underwent total small-intestinal evaluation by double-balloon endoscopy (DBE) both before and 8\u201314 months after RZB initiation in clinical practice. Endoscopic disease activity was assessed using the modified Simple Endoscopic Score for Crohn\u2019s Disease (mSES-CD). Clinical response (Crohn\u2019s Disease Activity Index [CDAI]), biomarker changes (C-reactive protein, leucine-rich alpha-2 glycoprotein), and endoscopic outcomes were evaluated. Results: Mean mSES-CD significantly decreased from 14.3 to 8.2 (p &lt; 0.001), indicating substantial mucosal improvement, particularly in the jejunum and deep ileum. Endoscopic remission (mSES-CD &lt;2) was achieved in 13.3% of patients. Clinical remission (CDAI &lt;150) occurred in 80% at week 12 and was sustained in 56% at 1 year. Significant biomarker improvements were observed. No progression of strictures was seen during follow-up. Conclusion: This study confirms the therapeutic efficacy of RZB for deep small-intestinal involvement in CD based on comprehensive DBE assessment. The results support the clinical utility of RZB in patients with refractory small-intestinal lesions, highlighting its potential to maintain 1 year disease control when ongoing mucosal inflammation is a concern. These findings underscore the importance of deep enteroscopic evaluation to optimize therapeutic strategies.<\/jats:p>","DOI":"10.1159\/000550396","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T14:50:33Z","timestamp":1770648633000},"page":"1-9","source":"Crossref","is-referenced-by-count":1,"title":["Therapeutic Efficacy of Risankizumab for Small-Intestinal Lesions in Crohn\u2019s Disease: A Retrospective Study Using Double-Balloon Endoscopy"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4994-016X","authenticated-orcid":false,"given":"Takeshi","family":"Yamamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4779-9708","authenticated-orcid":false,"given":"Tsunaki","family":"Sawada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Murate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3713-3072","authenticated-orcid":false,"given":"Takashi","family":"Hirose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Iida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Mizutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Yamao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Ishizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5814-3555","authenticated-orcid":false,"given":"Takuya","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8951-0952","authenticated-orcid":false,"given":"Takashi","family":"Honda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-143X","authenticated-orcid":false,"given":"Masanao","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3720-781X","authenticated-orcid":false,"given":"Hiroki","family":"Kawashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02175.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07674.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-020-01737-0"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.08.024"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.10.030"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.221"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05837-7"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2025.03.037"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0156-2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315671"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izaa086"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1203572"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.09.018"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1909094"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjac034"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00467-6"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/nri3738"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16551"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/den.14429"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izac076"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaf070"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2314585"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-025-02223-1"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000550396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:00:38Z","timestamp":1773248438000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000550396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":23,"URL":"https:\/\/doi.or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