Simultaneous Initiation of Carotegrast Methyl and Corticosteroids for the Induction of Remission in Moderately Active Ulcerative Colitis: Two Case Reports

Carotegrast methyl (CGM), an oral selective α4 integrin antagonist, has recently been approved in Japan for the induction of remission in patients with moderately active ulcerative colitis (UC).Although systemic corticosteroids remain standard therapy for remission induction, their use is limited by adverse effects, and evidence regarding the safety and efficacy of concomitantly used CGM and corticosteroids remains scarce.We report two cases of moderately active UC in which remission was successfully induced using concomitant CGM and systemic corticosteroids.In both patients, CGM was initiated together with oral prednisolone, followed by a planned steroid taper.Both patients showed prompt improvement in symptoms and inflammatory markers, with endoscopic improvement within two weeks.Steroids were successfully discontinued within four to five weeks, and sustained clinical remission was maintained without serious adverse events.These cases suggest that concomitant use of CGM and systemic corticosteroids may be a safe and effective strategy for remission induction in moderately active UC, potentially facilitating early steroid tapering.Further studies are warranted to clarify the optimal role and safety profile of this combination therapy.