{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:42:08Z","timestamp":1787668928833,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Ustekinumab (UST) has shown to be effective and safe in patients with moderate-to-severe UC in the UNIFI trials. However, real-life data on its effectiveness, particularly for histological remission, are still limited. To assess the real-world effectiveness and safety of UST in refractory UC patients. Methodology: This multicentric, retrospective cohort study included UC patients treated with UST from September 2020 to June 2023. The primary endpoint was steroid-free clinical remission (partial Mayo score of \u22642 with no subscore &gt; 1) at week 16. Secondary endpoints included clinical, endoscopic, histological response and remission. Results: 120 patients with moderate\u2013severe UC were included across 16 centers. Median disease duration was 11 years (1\u201374 y), and 81 (68%) patients had previously failed \u22652 biological therapies. At week 16, steroid-free clinical remission was achieved in 34% (41\/120) of patients, with endoscopic and histological remission in, respectively, 19% (23\/120) and 8% (3\/37). By week 52, 44% (38\/85) of patients were in steroid-free clinical remission, with endoscopic and histological remission, respectively, in 25% (13\/52) and 11% (5\/45). Active smoking was a negative predictor for steroid-free remission (OR 0.412, p = 0.011). UST drug persistence by week 52 was 70.8%. Active smoking (aOR 3.058, p = 0.02), prior vedolizumab non-response (OR 2.592, p = 0.03) and a high Nancy baseline score (OR 2.46, p = 0.04) were associated with early UST failure. No new safety signals were observed. Conclusions: In this real-life cohort, UST shows acceptable remission rates and high treatment persistence in refractory UC patients, with a favorable safety profile.<\/jats:p>","DOI":"10.3390\/jcm14186506","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T10:06:25Z","timestamp":1758017185000},"page":"6506","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ustekinumab in Ulcerative Colitis: A Real-Life Effectiveness Study Across Multiple Belgian Centers (SULTAN)"],"prefix":"10.3390","volume":"14","author":[{"given":"Tom","family":"Holvoet","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, UZ Gent, Corneel Heymanslaan 10, 9000 Gent, Belgium"},{"name":"Department of Gastroenterology, VITAZ, 9100 Sint Niklaas, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1264-4319","authenticated-orcid":false,"given":"Marie","family":"Truyens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, UZ Gent, Corneel Heymanslaan 10, 9000 Gent, Belgium"},{"name":"Department of Internal Medicine and Pediatrics, Gent University, 9000 Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Reenaers","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, CHU Liege, 4000 Liege, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Baert","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Delta, 8800 Roeselare, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn","family":"Vanden Branden","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, OLV Aalst, 9300 Aalst, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneline","family":"Cremer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hopital Erasme, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3279-1033","authenticated-orcid":false,"given":"Lieven","family":"Pouillon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Imelda, 2820 Bonheiden, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Dewint","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Maria Middelares, 9000 Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"Van Moerkercke","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Groeninge, 8500 Kortrijk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Rahier","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, CHU Namur, 5000 Namur, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liv","family":"Vandermeulen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, UZ Brussel, 1090 Brussel, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurgen","family":"Van Dongen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Sint Maarten, 2800 Mechelen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Sint Lucas, 9000 Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Lambrecht","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, AZ Damiaan, 8400 Oostende, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Vijverman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, CHR de la Citadelle, 4000 Liege, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Van Haecke","sequence":"additional","affiliation":[{"name":"Department of Pathology, UZ Gent, 9000 Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0736-2034","authenticated-orcid":false,"given":"Anne","family":"Hoorens","sequence":"additional","affiliation":[{"name":"Department of Pathology, UZ Gent, 9000 Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1817-7704","authenticated-orcid":false,"given":"Triana","family":"Lobaton","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, UZ Gent, Corneel Heymanslaan 10, 9000 Gent, Belgium"},{"name":"Department of Internal Medicine and Pediatrics, Gent University, 9000 Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"s1","DOI":"10.1136\/gutjnl-2019-318484","article-title":"British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults","volume":"68","author":"Lamb","year":"2019","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"384","DOI":"10.5009\/gnl210141","article-title":"Quality of Life in Newly Diagnosed Moderate-to-Severe Ulcerative Colitis: Changes in the MOSAIK Cohort Over 1 Year","volume":"16","author":"Jo","year":"2022","journal-title":"Gut Liver"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.dld.2021.03.002","article-title":"Quality of life in 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Liver Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2629","DOI":"10.1016\/j.cgh.2023.01.038","article-title":"Second\u2013Line Biologic Therapy Following Tumor Necrosis Factor Antagonist Failure: A Real\u2013World Propensity Score\u2013Weighted Analysis","volume":"21","author":"Ibing","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1080\/17474124.2023.2194632","article-title":"A critical review of ustekinumab for the treatment of active ulcerative colitis in adults","volume":"17","author":"Vieujean","year":"2023","journal-title":"Expert. Rev. Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1056\/NEJMoa1900750","article-title":"Ustekinumab as Induction and Maintenance Therapy for Ulcerative Colitis","volume":"381","author":"Sands","year":"2019","journal-title":"N. Engl. J. 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Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"otab002","DOI":"10.1093\/crocol\/otab002","article-title":"Real-World Effectiveness and Safety of Ustekinumab for Ulcerative Colitis From 2 Tertiary IBD Centers in the United States","volume":"3","author":"Hong","year":"2021","journal-title":"Crohn\u2019s Colitis 360"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1080\/14712598.2021.1981855","article-title":"One-year effectiveness and safety of ustekinumab in ulcerative colitis: A multicenter real-world study from Italy","volume":"21","author":"Chiappetta","year":"2021","journal-title":"Expert. Opin. Biol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1093\/ecco-jcc\/jjab070","article-title":"Effectiveness and Safety of Ustekinumab in Ulcerative Colitis: Real-world Evidence from the ENEIDA Registry","volume":"15","author":"Chaparro","year":"2021","journal-title":"J. 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Crohn\u2019s Colitis"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6506\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:46:15Z","timestamp":1760035575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":25,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14186506"],"URL":"https:\/\/doi.org\/10.3390\/jcm14186506","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]}}}