{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:21:10Z","timestamp":1789608070561,"version":"build-2803163510"},"reference-count":64,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Recent studies have investigated the effectiveness of second-line agents in patients with ulcerative colitis (UC) who have experienced failure with first-line biologics. Although cytapheresis (CAP) is an effective therapeutic strategy for refractory UC, the efficacy of second-line agents in patients with UC with previous CAP failure remains unexplored. Herein, we examined the efficacy of biologics in patients with refractory UC who experienced non-response or insufficient response to previous CAP. Methods: We retrospectively assessed the efficacy of biologics administered between January 2013 and June 2024 in patients with refractory UC who experienced non-response or insufficient response to previous CAP. Rates of clinical remission, steroid-free remission, and endoscopic improvement were also determined. Clinical remission was evaluated using Lichtiger\u2019s clinical activity index. Results: Eighty-one patients with refractory UC underwent CAP, thirty of whom were eligible for study inclusion. The use of biologics was associated with clinical and steroid-free remission rates of 75.9% and 44.8%, respectively. Clinical and steroid-free remission rates of biologics did not differ significantly between patients with an insufficient response to previous CAP and those with non-response to previous CAP. There were no significant differences in clinical or steroid-free remission rates of biologics between patients with steroid-dependent and steroid-refractory UC. Endoscopic improvement was observed in 54.5% of patients. Conclusions: Despite the limited number of patients, biologic therapy was effective in patients with refractory UC who had experienced a non-response or insufficient response to previous CAP. Accordingly, biologics may be a useful second-line therapy for patients with refractory UC who have failed CAP.<\/jats:p>","DOI":"10.3390\/jcm14186574","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T12:24:25Z","timestamp":1758198265000},"page":"6574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Biologics in Patients with Ulcerative Colitis Exhibiting Non-Response or Insufficient Response to Cytapheresis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-2805","authenticated-orcid":false,"given":"Masahiro","family":"Iizuka","sequence":"first","affiliation":[{"name":"Health Promotion Center, Japanese Red Cross Akita Hospital, 222-1 Kamikitade Saruta Aza Naeshirozawa, Akita City 010-1495, Japan"},{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Etou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Yorozu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bunichiro","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeya","family":"Edagawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiho","family":"Sagara","sequence":"additional","affiliation":[{"name":"Health Promotion Center, Japanese Red Cross Akita Hospital, 222-1 Kamikitade Saruta Aza Naeshirozawa, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiro-O","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenjiro","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Japanese Red Cross Akita Hospital, Akita City 010-1495, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/s41572-020-0205-x","article-title":"Ulcerative colitis","volume":"6","author":"Kobayashi","year":"2020","journal-title":"Nat. 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