Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Jun 14, 2026; 32(22): 118036
Published online Jun 14, 2026. doi: 10.3748/wjg.v32.i22.118036
Published online Jun 14, 2026. doi: 10.3748/wjg.v32.i22.118036
Sex-specific differences in the efficacy and prognosis of 5-aminosalicylic acid therapy for ulcerative colitis: A 20-year retrospective cohort study
Zhao-Shi Liu, Xiao-Feng Li, Department of Gastroenterology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
Zhao-Shi Liu, Hao Tang, Xiao-Yin Bai, Hong Yang, Jia-Ming Qian, Department of Gas
Hui-Min Zhang, Department of Gastroenterology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Author contributions: Liu ZS wrote the original draft; Liu ZS, Tang H, and Qian JM designed the study; Liu ZS, Tang H, and Zhang HM were responsible for developing the methodology; Liu ZS, Zhang HM, Bai XY, and Li XF collected and analyzed data; Liu ZS, Tang H, and Bai XY performed statistical analysis; Yang H, and Qian JM participated in the review and editing; all authors approved the final version.
Supported by the Health Research and Special Projects Grant of China, No. 201002020; and CAMS Innovation Fund for Medical Sciences, No. 2016-I2M-3-001.
Institutional review board statement: This study was approved by the Institutional Ethics Committee of Peking Union Medical College Hospital (Ethics approval No. S-K1889).
Informed consent statement: Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.
Corresponding author: Jia-Ming Qian, MD, Professor, Department of Gastroenterology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. qianjm@pumch.cn
Received: December 26, 2025
Revised: February 13, 2026
Accepted: March 9, 2026
Published online: June 14, 2026
Processing time: 156 Days and 12.8 Hours
Revised: February 13, 2026
Accepted: March 9, 2026
Published online: June 14, 2026
Processing time: 156 Days and 12.8 Hours
Core Tip
Core Tip: Real-world data concerning sex-specific differences in the response to and long-term outcomes of 5-aminosalicylic acid (5-ASA) therapy for ulcerative colitis (UC) in large-scale UC cohorts are lacking. This retrospective study analyzed 354 patients receiving 5-ASA treatment after 1:1 propensity score matching. Male patients had an increased chance of frequent UC flare-ups, less frequent and delayed endoscopic mucosal healing, and a higher risk of surgery. These findings emphasize the need for sex-adapted therapeutic strategies to optimize 5-ASA utilization and improve individualized UC management.