{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:39:52Z","timestamp":1776674392056,"version":"3.51.2"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hellenic Group for the study of IBD","award":["2022EOMIFNEmp1"],"award-info":[{"award-number":["2022EOMIFNEmp1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Ustekinumab has been approved for the treatment of moderate to severe ulcerative colitis. Real-world data regarding its efficacy and the discovery of predictive factors of response need to be studied further. We aimed to evaluate the efficacy and identify predictors of response to induction treatment with ustekinumab in patients with ulcerative colitis. Methods: This is a multicenter, prospective cohort study. Clinical response (CR) at week 16 was the primary endpoint, and steroid-free clinical remission (SFCRem) and endoscopic response were the secondary endpoints. Baseline histology, mucosal gene expression, and pharmacokinetics were studied for their effect on response to treatment. Results: We included 123 patients (mean age = 50.3 years). CR was recorded in 70.8% (75\/106), SFCRem in 48% (59\/123), endoscopic improvement in 71.4% (40\/56), and mucosal healing in 28.6% (16\/56). Higher PRO-stool frequency (OR = 0.49, p = 0.027), concomitant use of 5-ASA (OR = 3.69, p = 0.021), platelet number of \u2265284 \u00d7 109\/L (OR = 6.52, p = 0.001) at baseline, and a drop in the total count of platelets by 108\/L (OR = 1.23, p = 0.022) at week 8 were independently associated with CR. Elevated trough levels of ustekinumab at week 16 were associated with a higher probability of endoscopic improvement (median difference = 3784 ng\/mL, p = 0.013), with an optimal cut-off value of 3500 ng\/mL (AUC = 0.82, 95% CI: 0.66\u20130.96). Increased mucosal mRNA expression for IL-23 (p = 0.007) and IL-23R (p = 0.031) at baseline was associated with increased probability of CR. Higher continuous Geboes scores at baseline were associated with a lower probability of CR (OR = 0.80, p = 0.045), with an optimal cut-off value of 14 (AUC = 0.75, 95% CI: 0.57\u20130.93). Conclusions: Clinical, laboratory, and molecular markers may identify patients with ulcerative colitis who are more likely to respond to ustekinumab.<\/jats:p>","DOI":"10.3390\/diseases14040149","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T07:15:08Z","timestamp":1776669308000},"page":"149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Response to Induction Therapy with Ustekinumab in Patients with Ulcerative Colitis: Results from a National Study in Greece"],"prefix":"10.3390","volume":"14","author":[{"given":"Konstantina","family":"Chalakatevaki","sequence":"first","affiliation":[{"name":"3rd Academic Department of Internal Medicine, University of Athens-Sotiria Hospital-GI Unit, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9640-6634","authenticated-orcid":false,"given":"Georgios","family":"Kokkotis","sequence":"additional","affiliation":[{"name":"3rd Academic Department of Internal Medicine, University of Athens-Sotiria Hospital-GI Unit, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3295-6811","authenticated-orcid":false,"given":"Maria","family":"Gazouli","sequence":"additional","affiliation":[{"name":"Laboratory of Biology, Department of Basic Medical Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stratigoula","family":"Sakellariou","sequence":"additional","affiliation":[{"name":"Pathology Laboratory, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Vamvakaris","sequence":"additional","affiliation":[{"name":"Pathology Laboratory, Sotiria Hospital, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6137-4212","authenticated-orcid":false,"given":"Alexandros","family":"Chatzidakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Attikon University Hospital, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerasimos","family":"Gerasimatos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital G. Gennimatas, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-4038","authenticated-orcid":false,"given":"Maria","family":"Kalogirou","sequence":"additional","affiliation":[{"name":"2nd Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanellos","family":"Koustenis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Evangelismos Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitra","family":"Lazou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Theagenio Cancer Hospital of Thessaloniki, 54639 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0434-042X","authenticated-orcid":false,"given":"Afroditi","family":"Orfanidou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital Laiko, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Palatianou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital of Nikea and Pireaus, 18454 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0441-0598","authenticated-orcid":false,"given":"Evgenia","family":"Papathanasiou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital Alexandra, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Psistakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Venizeleio General Hospital, 71409 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-8700","authenticated-orcid":false,"given":"Christos","family":"Sotiropoulos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General University Hospital of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evaggelia","family":"Anagnostopoulou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Saint George General Hospital of Chania, 73300 Chania, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2026-9678","authenticated-orcid":false,"given":"Konstantinos","family":"Argyriou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University General Hospital of Larissa, 41334 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matina-Lydia","family":"Chatzinikolaou","sequence":"additional","affiliation":[{"name":"Metropolitan General Hospital, 15564 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0554-5256","authenticated-orcid":false,"given":"Kalliopi","family":"Foteinogiannopoulou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University General Hospital of Heraklion, 71500 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0176-3598","authenticated-orcid":false,"given":"Olga","family":"Giouleme","sequence":"additional","affiliation":[{"name":"2nd Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Kapsoritakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University General Hospital of Larissa, 41334 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pantelis","family":"Karatzas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital Laiko, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3552-3074","authenticated-orcid":false,"given":"Konstantinos","family":"Karmiris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Venizeleio General Hospital, 71409 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7395-6594","authenticated-orcid":false,"given":"Nikolaos","family":"Kiriakos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, 401 General Military Hospital, 11525 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2773-2709","authenticated-orcid":false,"given":"Ioannis","family":"Koutroubakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University General Hospital of Heraklion, 71500 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8025-0808","authenticated-orcid":false,"given":"Christos","family":"Liatsos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, 401 General Military Hospital, 11525 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-8627","authenticated-orcid":false,"given":"Aikaterini","family":"Mantaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Saint George General Hospital of Chania, 73300 Chania, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5302-5450","authenticated-orcid":false,"given":"Gerasimos","family":"Mantzaris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Evangelismos Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7345-5298","authenticated-orcid":false,"given":"Panagiotis","family":"Markopoulos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Metaxa Cancer Hospital of Athens, 18537 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-6777","authenticated-orcid":false,"given":"Georgios","family":"Michalopoulos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital G. Gennimatas, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7371-8601","authenticated-orcid":false,"given":"Spiros","family":"Michopoulos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital Alexandra, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Polymeros","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Attikon University Hospital, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8635-6400","authenticated-orcid":false,"given":"Konstantinos","family":"Soufleris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Theagenio Cancer Hospital of Thessaloniki, 54639 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Theocharis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General University Hospital of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angeliki","family":"Theodoropoulou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Venizeleio General Hospital, 71409 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7371-285X","authenticated-orcid":false,"given":"Eftychia","family":"Tsironi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Metaxa Cancer Hospital of Athens, 18537 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Tzouvala","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital of Nikea and Pireaus, 18454 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0918-1587","authenticated-orcid":false,"given":"Nikos","family":"Viazis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Evangelismos Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8154-0444","authenticated-orcid":false,"given":"Eirini","family":"Zacharopoulou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital of Nikea and Pireaus, 18454 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evanthia","family":"Zampeli","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, General Hospital Alexandra, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-5717","authenticated-orcid":false,"given":"Giorgos","family":"Bamias","sequence":"additional","affiliation":[{"name":"3rd Academic Department of Internal Medicine, University of Athens-Sotiria Hospital-GI Unit, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0140-6736(23)00966-2","article-title":"Ulcerative Colitis","volume":"402","author":"Honap","year":"2023","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rubin, D.C., Shaker, A., and Levin, M.S. 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