Publication Name	World Journal of Gastrointestinal Pharmacology and Therapeutics
Manuscript ID	120771
DOI	10.4292/wjgpt.120771
Country	United Kingdom

Category	Gastroenterology & Hepatology
Manuscript Type	Case Report
Article Title	Beyond class switching in multi-refractory inflammatory bowel disease: Nine case reports and review of literature
Manuscript Source	Invited Manuscript
All Author List	Jonathan Soldera, Maria Antonia Selbach Pertile, Leticia Nodari Carobin, Daniel Jun Funatsu Brambilla and Eduardo Brambilla
Funding Agency and Grant Number
Corresponding Author	Jonathan Soldera, MD, PhD, Department of Tutor, Gastroenterology and Acute Medicine, University of South Wales, Llantwit Road, Pontypridd, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com
Key Words	Refractory inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Advanced combination therapy; Janus kinase inhibitors; Vedolizumab; Tofacitinib; Upadacitinib; Guselkumab; Case report
Core Tip	Multi-refractory inflammatory bowel disease often stalls at a “near-working” partial response to an advanced therapy. This case series (n = 9) suggests that, in carefully selected patients, consolidating partial mechanistic control with structured optimization and add-on advanced combination therapy (an oral Janus kinase inhibitor plus a biologic) may convert incomplete response into deep remission and delay surgery. This approach requires phenotype-driven selection, objective reassessment anchored to endoscopic and biochemical endpoints, rigorous infection exclusion, close monitoring, and predefined stopping rules - recognizing that timely colectomy remains appropriate when objective control fails.
Citation	Soldera J, Pertile MAS, Carobin LN, Brambilla DJF, Brambilla E. Beyond class switching in multi-refractory inflammatory bowel disease: Nine case reports and review of literature. World J Gastrointest Pharmacol Ther 2026; In press DOI: https://doi.org/10.4292/wjgpt.120771
PDF	120771-in-press.pdf

Received	2026-03-09 06:23
Peer-Review Started	2026-03-09 06:27
First Decision by Editorial Office Director	2026-04-23 05:07
Return for Revision	2026-04-23 05:07
Revised	2026-05-15 01:14
Publication Fee Transferred
Second Decision by Editor	2026-06-10 02:33
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-10 03:21
Articles in Press	2026-06-10 03:21
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2150-5349 (online)
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