Intestinal Research

Original Articles

IBD

Filgotinib effectiveness and safety as second or third-line therapy in patients with ulcerative colitis: data from a real-world study: Antonio Tursi, Giammarco Mocci, Francesco Costa, Linda Ceccarelli, Edoardo Savarino, Caterina De Barba, Caterina Mucherino, Elvira D’Antonio, Laura Montesano, Manuela Marzo, Franco Scaldaferri, Daniele Napolitano, Daniela Pugliese, Antonietta Gerarda Gravina, Raffaele Pellegrino, Rocco Spagnuolo, Francesco Luzza, Antonio Cuomo, Laura Donnarumma, Giovanni Maconi, Giovanni Cataletti, Lorenzo Bertani, Giorgia Bodini, Andrea Pasta, Simona Piergallini, Mariaelena Serio, Antonella Scarcelli, Pietro Capone, Fabio Cortellini, Stefano Rodino, Ladislava Sebkova, Giuliana Vespere, Silvia Sedda, Vittorio D’Onofrio, Leonardo De Luca, Federica Gaiani, Stefano Kayali, Cristiano Pagnini, Maria Giovanna Graziani, Maria Carla Di Paolo, Leonardo Allegretta, Alessia Immacolata Cazzato, Stefano Scorza, Antonio Ferronato, Davide Giuseppe Ribaldone, Giovanni Aragona, Patrizia Perazzo, Giacomo Forti, Michela Di Fonzo, Federico Iacopini, Roberta Pica, Claudio Cassieri, Francesca Maria Onidi, Paolo Usai Satta, Walter Elisei, Marcello Picchio, Alfredo Papa; Intest Res 2026;24(2):341-351. Published online September 29, 2025; DOI: https://doi.org/10.5217/ir.2025.00067

Background/Aims
Real-world data on the use of filgotinib (FILGO) in patients with ulcerative colitis (UC) are limited. This study aims to provide consistent results on the effectiveness and safety of FILGO in treating UC.
Methods
A retrospective assessment of clinical and endoscopic activity was conducted in a cohort of patients with UC according to the full Mayo score. The primary co-endpoints of the study were the evaluation of the effectiveness and safety of FILGO.
Results
We enrolled 102 patients with a median follow-up of 24 weeks (interquartile range, 8–24 weeks). At 8 weeks and the end of follow-up, clinical remission was achieved by 38 (37.2%) and 47 (46.1%) patients, respectively. Clinical remission was achieved in 13 of 18 patients (72.2%) receiving first-line therapy, 7 of 19 patients (36.8%) receiving second-line therapy, and 27 of 65 patients (41.5%) receiving third-line therapy (P= 0.002). Clinical remission at 8 weeks predicted clinical remission at the end of follow-up (P= 0.021). Age > 40 years (P= 0.046) and being on second- or third-line of treatment (P= 0.005) were negative predictors for clinical remission. Seventy-one patients (69.6%) achieved a clinical response. At endoscopic evaluation, mucosal healing was observed in 18 out of 30 patients (60.0%). Steroid-free remission was present in 38 out of 46 patients (82.6%). Five patients (4.9%) needed colectomy. Adverse events were recorded in 6 patients (5.8%): 2 cases (2%) were severe, requiring discontinuation of FILGO.
Conclusions
Our real-world data confirms that FILGO is safe and effective for patients with UC. Its efficacy is significantly improved when used as a first-line treatment.

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Comparative Effectiveness and Safety of Tofacitinib, Filgotinib, and Upadacitinib in Ulcerative Colitis: A Multicenter Real-World Cohort Study
Antonio Tursi, Andrea Pasta, Walter Elisei, Brigida Barberio, Giammarco Mocci, Edoardo V. Savarino, Caterina de Barba, Giovanni Maconi, Giovanni Cataletti, Franco Scaldaferri, Daniele Napolitano, Francesco Costa, Linda Ceccarelli, Manuela Marzo, Rita Mont
Advances in Therapy.2026;[Epub] CrossRef
Upadacitinib’s Effectiveness and Safety as a Second- or Third-Line Therapy in Patients with Ulcerative Colitis: Data from a Real-World Study
Giammarco Mocci, Antonio Tursi, Franco Scaldaferri, Daniele Napolitano, Daniela Pugliese, Giovanni Maconi, Giovanni Cataletti, Roberta Pica, Claudio Cassieri, Edoardo Vincenzo Savarino, Caterina De Barba, Francesco Costa, Linda Ceccarelli, Manuela Marzo,
Journal of Clinical Medicine.2025; 14(21): 7801. CrossRef

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Miscellaneous

Bowel movement alterations predict the severity of diverticular disease and the risk of acute diverticulitis: a prospective, international study: Antonio Tursi, Daniele Piovani, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Marcello Picchio, Gisella Figlioli, Gabrio Bassotti, Leonardo Allegretta, Maria Laura Annunziata, Mauro Bafutto, Maria Antonia Bianco, Raffaele Colucci, Rita Conigliaro, Dan L. Dumitrascu, Ricardo Escalante, Luciano Ferrini, Giacomo Forti, Marilisa Franceschi, Maria Giovanna Graziani, Frank Lammert, Giovanni Latella, Daniele Lisi, Giovanni Maconi, Debora Compare, Gerardo Nardone, Lucia Camara de Castro Oliveira, Chaves Oliveira Enio, Savvas Papagrigoriadis, Anna Pietrzak, Stefano Pontone, Ieva Stundiene, Tomas Poškus, Giuseppe Pranzo, Matthias Christian Reichert, Stefano Rodino, Jaroslaw Regula, Giuseppe Scaccianoce, Franco Scaldaferri, Roberto Vassallo, Costantino Zampaletta, Angelo Zullo, Erasmo Spaziani, Stefanos Bonovas, Alfredo Papa, Silvio Danese, DICA International Group; Intest Res 2025;23(1):96-106. Published online August 12, 2024; DOI: https://doi.org/10.5217/ir.2024.00046

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Patients with diverticular disease (DD) frequently have abnormal bowel movements. However, it is unknown whether the entity of these alterations is associated with the severity of DD. We aimed to assess bowel habits and their relationship with the severity of DD according to Diverticular Inflammation and Complication Assessment (DICA) classification, Combined Overview on Diverticular Assessment (CODA) score, and fecal calprotectin (FC).
Methods
An international, multicenter, prospective cohort study was conducted in 43 centers. A 10-point visual analog scale (VAS) was used to assess the severity of constipation and diarrhea. The association of constipation and diarrhea with DICA classification, CODA score, and basal FC was tested using non-parametric tests. Survival methods for censored observations were applied to test the association of constipation and diarrhea with the incidence of acute diverticulitis over a 3-year follow-up.
Results
Of 871 patients with DD were included in the study. Of these, 208 (23.9%) and 199 (22.9%) reported a VAS score for constipation and diarrhea at least 3 at baseline, respectively. Higher constipation and diarrhea scores were associated with increasing DICA classification, CODA score and basal FC (P< 0.001). Constipation and diarrhea scores were independently associated with an increased hazard of developing acute diverticulitis (hazard ratio [HR]_constipation = 1.15 per 1-VAS point increase, 95% confidence interval [CI], 1.04–1.27; P=0.004; and HR_diarrhea =1.14; 95% CI, 1.03–1.26; P=0.014, respectively).
Conclusions
In newly diagnosed patients with DD, higher endoscopic and combined scores of DD severity were associated with higher scores of constipation and diarrhea at baseline. Both constipation and diarrhea were independent prognostic factors of acute diverticulitis.

Citations

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Global guidelines on diverticular disease of the colon: the Fiesole Consensus report
Antonio Tursi, Giovanni Brandimarte, Francesco Di Mario, Wenjie Ma, Juozas Kupcinskas, Jaroslaw Regula, Giovanni Maconi, Peter Malfertheiner, Giovanni Barbara, Neil Stollman, Savvas Papagrigoriadis, Thomas Golda, Antonio Amato, Mauro Bafutto, Gabrio Basso
Gut.2025; : gutjnl-2025-336902. CrossRef

9,160 View
160 Download
3 Web of Science
1 Crossref

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