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. Sep 14, 2026; 32(34): 117240
Published online Sep 14, 2026. doi: 10.3748/wjg.117240
Published online Sep 14, 2026. doi: 10.3748/wjg.117240
Real-world inflammatory bowel disease-modification outcomes: A narrative review
Neeraj Narula, Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton L8N 3ZN, Ontario, Canada
Shashi Adsul, Department of Gastroenterology, Takeda Pharmaceutical International AG, Zurich 8152, Switzerland
Walter Reinisch, Department of Medicine III, Division for Gastroenterology and Hepatology, Medical University of Vienna, Vienna A-1090, Austria
Author contributions: Narula N, Adsul S, and Reinisch W contributed to the study conceptualization, data interpretation, draft preparation, and review; all authors have read and approved the final version of the manuscript for submission.
AI contribution statement: No AI tools were used in the development of this manuscript.
Conflict-of-interest statement: Neeraj Narula holds a McMaster University AFP Clinician Researcher Award and has received consulting fees from AbbVie, Bristol Myers Squibb, Celltrion, Eli Lilly, Fresenius Kabi, Innomar Strategies, Iterative Health, Iterative Scopes, Janssen, Organon, Pfizer, and Takeda, and lecture fees from AbbVie, BIOJAMP, Celltrion, Janssen, Pfizer, and Takeda; Shashi Adsul is an employee of and holds stock/options in Takeda; Walter Reinisch has received research grants from AbbVie, Janssen, Pfizer, and Takeda; consulting fees from AbbVie, AOP Orphan, Bioclinica, Bristol Myers Squibb, Calyx, Eli Lilly, Galapagos, Gilead, Index Pharma, Janssen, Landos Biopharma, Microbiotica, MSD, Pfizer, Protagonist, Seres Therapeutics, Takeda, and Teva Pharmaceuticals; and speaker bureau fees from AbbVie, Celltrion, Galapagos, MSD, Janssen, and Takeda.
Corresponding author: Walter Reinisch, MD, PhD, Professor, Department of Medicine III, Division for Gastroenterology and Hepatology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna A-1090, Austria. walter.reinisch@meduniwien.ac.at
Received: December 2, 2025
Revised: March 5, 2026
Accepted: July 27, 2026
Published online: September 14, 2026
Processing time: 260 Days and 9.4 Hours
Revised: March 5, 2026
Accepted: July 27, 2026
Published online: September 14, 2026
Processing time: 260 Days and 9.4 Hours
Core Tip
Core Tip: The standard protocol items: Recommendations for interventional trials (SPIRIT) consensus has recommended disease-modification endpoints for use in clinical trials in patients with inflammatory bowel disease (IBD) to help determine if this approach can prevent disease progression. Before such studies are conducted, real-world evidence can be informative. This review of real-world studies utilizing the SPIRIT consensus endpoints identified considerable gaps in the use of these recommended disease-modification endpoints. Therefore, there remains a need to incorporate SPIRIT recommended disease-modification endpoints in prospective real-world studies in patients with IBD receiving advanced treatments.