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World J Gastroenterol. May 21, 2026; 32(19): 117160
Published online May 21, 2026. doi: 10.3748/wjg.v32.i19.117160
Published online May 21, 2026. doi: 10.3748/wjg.v32.i19.117160
Letter to the Editor: Missing mechanistic data and small inflammatory bowel disease cohorts: Key barriers in ustekinumab switching
Qin-Jian Wang, Guang-Rong Lu, Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Zheng Zhu, The Second School of Medicine, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Co-first authors: Qin-Jian Wang and Zheng Zhu.
Author contributions: Wang QJ and Zhu Z contributed to manuscript writing and editing as co-first authors; Lu GR contributed to conceptualization and critical revisions; all authors have read and approved the final manuscript.
AI contribution statement: During the process of writing the manuscript, I only used translation tools like DeepL and did not use AI tools such as ChatGPT. The main body of the paper has not been generated using AI tools. Only DeepL was used to translate and polish some sentences, without using AI tools to analyze data or assist in manuscript writing. AI tools were not involved in the design of the research or the interpretation of the results.
Supported by Wenzhou Science and Technology Bureau, No. Y20240207.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Guang-Rong Lu, Deputy Chief Physician, Department of Gastroen
Received: December 1, 2025
Revised: January 24, 2026
Accepted: February 12, 2026
Published online: May 21, 2026
Processing time: 169 Days and 18.8 Hours
Revised: January 24, 2026
Accepted: February 12, 2026
Published online: May 21, 2026
Processing time: 169 Days and 18.8 Hours
Core Tip
Core Tip: Kritzinger et al report high treatment persistence and stable clinical outcomes after non-medical switching from originator ustekinumab to its biosimilar in inflammatory bowel disease. While reassuring, the findings derive from a cohort of long-term, stable responders and lack systematic evaluation of objective endpoints such as endoscopic healing. These limitations restrict generalizability to higher-risk patients – those with active or partially controlled disease – at the time of switch. Future studies must incorporate treat-to-target endpoints and focus on vulnerable subgroups to guide individualized biosimilar conversion strategies in real-world practice.