{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:47:35Z","timestamp":1785422855712,"version":"3.56.0"},"reference-count":53,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"crossref","award":["23HXFH026"],"award-info":[{"award-number":["23HXFH026"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"crossref"}]},{"award":["23HXFH026"],"award-info":[{"award-number":["23HXFH026"]}],"id":[{"id":"https:\/\/ror.org\/007mrxy13","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: IL-23p19 inhibitors have recently gained approval for treating moderate-to-severe Crohn\u2019s disease (CD). Nevertheless, their comparative efficacy relative to each other and to the IL-12\/23 inhibitor ustekinumab (UST) is controversial. Therefore, this study evaluated risankizumab (RZB), mirikizumab (MRK), guselkumab (GUS), and UST for inducing and maintaining clinical and endoscopic remission in the moderate-to-severe CD population. Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched until 4 November 2025. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes. The clinical and endoscopic remission\/response during induction and maintenance phases was examined through a frequentist network meta-analysis (NMA). Subgroup analyses were carried out in the biologic-na\u00efve population and those with prior biologic failure. Results: This NMA included 15 RCTs within 11 studies with 7747 patients. Relative to UST, IL-23p19 inhibitors demonstrated superior efficacy during induction and maintenance therapy. For clinical remission during the induction, GUS &lt; 600 mg displayed significantly greater efficacy than UST 6 mg\/kg (RR: 1.34 [95% CI: 1.06\u20131.70]). For endoscopic remission during the induction, both RZB &gt; 600 mg (RR: 1.66 [95% CI: 1.14\u20132.41]) and RZB \u2264 600 mg (RR: 1.65 [95% CI: 1.21\u20132.25]) were superior to UST 6 mg\/kg. During maintenance therapy, 200 mg GUS achieved a higher rate of endoscopic remission than UST (RR: 2.04 [95% CI: 1.09\u20133.49]). According to the SUCRA rankings, IL-23p19 inhibitors, particularly GUS and RZB, consistently ranked above UST across all evaluated outcomes. Conclusions: IL-23p19 inhibitors demonstrated superior efficacy in comparison to the IL-12\/23 inhibitor UST in the moderate-to-severe CD population. Further high-quality, long-term, multicenter RCTs and real-world studies could confirm these findings.<\/jats:p>","DOI":"10.3390\/jcm15145593","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:12:38Z","timestamp":1784257958000},"page":"5593","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing the Efficacy of Advanced Interleukin Inhibitors for Crohn\u2019s Disease: A Systematic Review and Network Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0103-0568","authenticated-orcid":false,"given":"Qiuyue","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengqi","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.14309\/ajg.0000000000003465","article-title":"ACG clinical guideline: Management of Crohn\u2019s disease in adults","volume":"120","author":"Lichtenstein","year":"2025","journal-title":"Am. 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