ArticleCrohn's & colitis 3602026
Comparative effectiveness and safety of risankizumab vs ustekinumab in patients with Crohn's disease: a propensity score-matched multicenter retrospective cohort study.
Article in Crohn's & colitis 360, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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11 authors.
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Abstract
Background: In the SEQUENCE trial, risankizumab was non-inferior for clinical remission and superior for endoscopic remission compared to ustekinumab in anti-TNF-exposed Crohn's disease (CD) patients. Given unclear results in real-world settings, we aimed to evaluate whether these findings translate to real-world advanced therapy-exposed and naïve CD cohorts. Methods: A retrospective cohort study using the TriNetX database with 1:1 propensity-score matching (PSM) analyzed 2 CD cohorts (advanced therapy-exposed and naïve) from inception to March 29, 2026. Primary outcomes were corticosteroid use, hospitalization, emergency department (ED) visits, intestinal surgery, intestinal complications, C-reactive protein (CRP) ≥ 10 mg/L, and therapy switching. Secondary outcomes included venous thromboembolism (VTE), major adverse cardiovascular events (MACE), and opportunistic infections. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with outcomes assessed at 12 and 24 months. Results: After PSM, each group in the advanced therapy-exposed cohort comprised 1799 patients, and each group in the advanced therapy-naïve cohort comprised 1776 patients. In the advanced therapy-exposed cohort, compared with ustekinumab, the risankizumab group had a statistically significant lower odds of ED visits, intestinal fistula, CRP ≥10 mg/L, MACE, and opportunistic infections at 12 months, while hospitalization (OR = 0.67, 95% CI, 0.50-0.91), ED visits (OR = 0.49, 95% CI, 0.35-0.68), overall intestinal surgery (OR = 0.68, 95% CI, 0.52-0.90), small intestine surgery (OR = 0.71, 95% CI, 0.52-0.99), large intestine surgery (OR = 0.72, 95% CI, 0.53-0.97), intestinal obstruction (OR = 0.69, 95% CI, 0.51-0.93), intestinal fistula (OR = 0.53, 95% CI, 0.36-0.78), CRP ≥10 mg/L (OR: 0.62, 95% CI, 0.46-0.85), MACE, and opportunistic infections at 24 months. Similarly, in the naïve cohort, compared with ustekinumab, risankizumab had a statistically significant lower odds of only CRP ≥10 mg/L at 12 months, while hospitalization, ED visits, overall intestinal surgery, small intestine surgery, large intestine surgery, anal surgery, overall complication of intestines, intestinal obstruction, switching to another advanced therapy, CRP ≥10 mg/L, and opportunistic infections at 24 months. Conclusions: In real-world practice, risankizumab was associated with modestly more favorable outcomes in patients with prior advanced therapy exposure, whereas differences became more apparent at 24 months in advanced therapy-naïve patients. Prospective studies are needed to confirm these findings.
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