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letter
. 2026 Mar 5;17(1):114412. doi: 10.4292/wjgpt.v17.i1.114412

Table 2.

Comparative context for biologic switch strategies after ustekinumab failure in Crohn’s disease

Parameter
Risankizumab
Vedolizumab
Anti-TNF
Ref. Colwill et al[6], 2025 Bressler et al[14], 2021 Allez et al[15], 2010
Study design Single-center retrospective Multicenter retrospective Various retrospective
Sample size (n) 51 78 Approximately 50-100 per cohort
Follow-up 9 months 12 months 6-12 months
Clinical remission rate 94.4% (34/36) 39% (at 12 months) Approximately 20%-40% (variable)
Biomarker improvement (CRP/FCal) Significant (P < 0.001) Modest Modest to significant
Key strengths High remission rates; excellent safety profile in this cohort Distinct gut-selective mechanism; well-established safety Extensive clinical experience; potential for dose optimization
Key limitations Single-center; no endoscopic data; potential for selection bias Lower remission rates in this setting Immunogenicity; potential for attenuated response in later lines of therapy

TNF: Tumor necrosis factor; CRP: C-reactive protein; FCal: Fecal calprotectin.