Beyond class switching in multi-refractory inflammatory bowel disease: Nine case reports and review of literature.

Jonathan Soldera, Maria Antonia Selbach Pertile, Leticia Nodari Carobin, Daniel Jun Funatsu Brambilla, Eduardo Brambilla

Abstract readCase Reports

PubMed Full text at PMC Publisher

In one paragraph

Article in World journal of gastrointestinal pharmacology and therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jonathan SolderaTutor, MSc Acute Medicine and Gastroenterology, University of South Wales in association with Learna Ltd, University of South Wales, Cardiff CF37 1DL, United Kingdom.

Maria Antonia Selbach PertileSchool of Medicine, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Rio Grande do Sul, Brazil.

Leticia Nodari CarobinSchool of Medicine, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Rio Grande do Sul, Brazil.

Daniel Jun Funatsu BrambillaSchool of Medicine, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Rio Grande do Sul, Brazil.

Eduardo BrambillaDepartment of Clinical Gastroenterology, Universidade de Caxias do Sul, Caxias do Sul 95070-560, RS, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA clinically relevant subset of patients with inflammatory bowel disease (IBD) remain partial responders despite multiple advanced therapies. In this setting, reflexive class switching risks forfeiting incremental mechanistic gains, whereas a deliberate "build-on-partial-response" strategy - through dose optimization, extended induction, and, in selected cases, advanced combination therapy (ACT) [an oral Janus kinase inhibitor (iJAK) plus a biologic] - may consolidate disease control. However, real-world data supporting ACT remain limited, particularly regarding phenotype-driven selection, objective reassessment, and safety considerations. CASE SUMMARY: We report nine multi-refractory IBD patients [ulcerative colitis (UC),

conclusionIn multi-refractory IBD, add-on ACT may convert partial response into deep remission, averting surgery in selected patients.

Indexed as

Advanced combination therapyCase reportCrohn’s diseaseGuselkumabJanus kinase inhibitorsRefractory inflammatory bowel diseaseTofacitinibUlcerative colitisUpadacitinibVedolizumab

Identifiers

PMID42707483

DOI10.4292/wjgpt.120771

PMCPMC13548183

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.