Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Verstockt, B; Taelman, T; Din, S; Vavricka, SR; Blesl, A; Zabana, Y; Van, Moerkercke, W; Kiudelis, V; de, la, Revilla, Negro, J; Maillard, MH; Savarino, EV; Teich, N; Macaigne, G; Truyens, M; Ribaldone, DG; Barreiro-de, Acosta, M; Wildt, S; Rivière, P; Fumery, M; Amiot, A; Marsal, J; Tontini, GE; Levartovsky, A; Vieujean, S; Somers, M; Cremer, A; Lutakov, I; Cohen, NA; Dewit, S; Bajer, L; Rahier, JF; Backman, AS; Nancey, S; Choden, T; Van, Dongen, J; Rogler, G; Lenfant, M; Finlayson, M; Münch, A; Julsgaard, M.
Real-world effectiveness of advanced therapies in microscopic colitis.
Clin Gastroenterol Hepatol. 2025; Doi: 10.1016/j.cgh.2025.12.019
PubMed FullText FullText_MUG

Co-Autor*innen der Med Uni Graz: Blesl Andreas
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Abstract:: BACKGROUND AND AIMS: Microscopic colitis (MC) is a leading cause of chronic diarrhoea, particularly in older adults. While many patients respond to budesonide, refractory and dependent cases pose major therapeutic challenges. Although the off-label use of advanced IBD therapies is expanding, robust real-world data remain scarce. METHODS: Through the ECCO CONFER network, we conducted a multinational, retrospective study in MC patients treated with biologics or small molecules following budesonide failure or intolerance. We systematically analyzed clinical outcomes, treatment durability, and predictors of therapeutic success. RESULTS: Among 229 treatment cycles in 142 patients, anti-TNF agents were most frequently initiated (55.9%), followed by vedolizumab (28.8%) and JAK inhibitors (9.2%). Short-term clinical response and remission rates were highest with JAK inhibitors (95.2% and 81.0%, respectively), significantly outperforming anti-TNFs, vedolizumab, and ustekinumab (p<0.01). Long-term drug persistence mirrored these findings: JAK inhibitors demonstrated a markedly lower discontinuation rate (23.8%) compared to other agents (56.3%, OR 5.07, 95% CI 1.52-16.9, p = 0.008). Multivariate analysis confirmed drug class as the only independent predictor of therapy continuation. Despite advanced therapies, 4.2% of patients ultimately required surgical intervention. CONCLUSION: This real-world study demonstrates the promising short- and long-term effectiveness of advanced therapies-particularly JAK inhibitors-in budesonide-refractory and budesonide-dependent MC. These findings pave the way for dedicated prospective trials and highlight evolving therapeutic strategies in MC.