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. Jul 28, 2026; 32(28): 119462
Published online Jul 28, 2026. doi: 10.3748/wjg.119462
Published online Jul 28, 2026. doi: 10.3748/wjg.119462
Biosimilars in inflammatory bowel disease: Beyond evidence, toward trust and implementation
Chuong Dinh Nguyen, Luan Minh Dang, Department of Gastroenterology, University Medical Center, Ho Chi Minh City 700000, Viet Nam
Chuong Dinh Nguyen, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Luan Minh Dang, Department of Internal Medicine and Gastro-Hepato Integrated Research Team (GHIRT-002.TCM2025), School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Viet Nam
Author contributions: Dang LM conceived the review, performed the primary drafting, and developed the proposed clinical framework; Nguyen CD contributed to conceptualization, critical revision, and manuscript editing; both authors interpreted the literature, approved the final manuscript, and agree to be accountable for all aspects of the work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Luan Minh Dang, MD, Lecturer, Department of Gastroenterology, University Medical Center, No. 215 Hong Bang Street, Cho Lon Ward, Ho Chi Minh City 700000, Viet Nam. luan.dm@umc.edu.vn
Received: January 28, 2026
Revised: February 15, 2026
Accepted: April 8, 2026
Published online: July 28, 2026
Processing time: 165 Days and 14.2 Hours
Revised: February 15, 2026
Accepted: April 8, 2026
Published online: July 28, 2026
Processing time: 165 Days and 14.2 Hours
Core Tip
Core Tip: Biosimilars in inflammatory bowel disease have moved beyond a narrow question of pharmacological equivalence. Although current evidence supports their efficacy, safety, and use across multiple clinical scenarios, adoption remains limited by nocebo-related discontinuation, physician hesitation, and system-level implementation barriers. This opinion review synthesizes current evidence, examines persistent controversies, and proposes a pragmatic 5-step framework for biosimilar initiation or switching in routine care. It also highlights the special challenges of resource-limited settings and introduces the concept of a “nocebo-prone environment” as a practical lens for understanding barriers to equitable biosimilar integration.