Publication Name	World Journal of Gastroenterology
Manuscript ID	117160
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Letter to the Editor
Article Title	Missing mechanistic data and small inflammatory bowel disease cohorts: Key barriers in ustekinumab switching
Manuscript Source	Invited Manuscript
All Author List	Qin-Jian Wang, Zheng Zhu and Guang-Rong Lu
Funding Agency and Grant Number	Funding Agency Grant Number Wenzhou Science and Technology Bureau No. Y20240207
Corresponding Author	Guang-Rong Lu, Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, No. 109 Xueyuan Western Road, Wenzhou 325000, Zhejiang Province, China. 290636246@qq.com
Key Words	Inflammatory bowel disease; Ustekinumab; Biosimilar switching; Therapeutic drug monitoring; Treat-to-target strategy; Nocebo effect; Shared decision-making
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.
Citation	Wang QJ, Zhu Z, Lu GR. Missing mechanistic data and small inflammatory bowel disease cohorts: Key barriers in ustekinumab switching. World J Gastroenterol 2026; In press

Received	2025-12-01 01:32
Peer-Review Started	2025-12-03 09:10
First Decision by Editorial Office Director	2026-01-15 07:29
Return for Revision	2026-01-15 07:29
Revised	2026-01-24 05:28
Publication Fee Transferred
Second Decision by Editor	2026-02-12 02:48
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-02-12 11:56
Articles in Press	2026-02-12 11:56
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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