What does this research mean for the field?

Advanced inflammatory bowel disease therapies significantly improve the likelihood of bowel urgency remission compared to placebo. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

This research aims to analyze the impact of advanced therapies on bowel urgency in individuals with inflammatory bowel diseases.

February 16, 2026Open Access

Poster Session II - A284 IMPROVEMENT OF BOWEL URGENCY WITH ADVANCED INFLAMMATORY BOWEL DISEASE THERAPIES: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Key Points

This research aims to analyze the impact of advanced therapies on bowel urgency in individuals with inflammatory bowel diseases.
Conducted a systematic review and meta-analysis of studies
Searched MEDLINE, Embase, and Cochrane databases
Included studies reporting bowel urgency as a binary outcome
Performed subgroup analysis by IBD subtype
Calculated risk ratios with 95% confidence intervals
Included 44 studies: 29 randomized controlled trials and 15 post-hoc studies
Induction therapies showed a 77% increased likelihood of bowel urgency remission
Maintenance therapies showed a 140% increased likelihood of bowel urgency remission
No major differences found among anti-interleukin-23 agents and JAK-inhibitor therapy
Rapid and sustained improvement in bowel urgency was observed across therapies

Abstract

Abstract Background Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease, are chronic conditions that significantly affect quality of life. Bowel urgency is a particularly disruptive symptom of IBD, which is often underreported in clinical trials. Aims This systematic review and meta-analysis aimed to examine the effects of IBD therapies on bowel urgency, focusing on the degree and durability of improvement. Methods MEDLINE, Embase, and Cochrane databases were searched in December 2024 for studies that reported a bowel urgency outcome for IBD therapies. Only studies reporting absence of BU as a quantitative, binary outcome were included in the meta-analysis. A subgroup analysis was also performed by IBD subtype (Crohn’s disease vs ulcerative colitis). Risk ratios with 95% confidence intervals were reported. Results Forty-four studies were included, including 29 randomized controlled trials and 15 post-hoc studies of RCTs representing a total of 8 therapeutic agents. There was significantly improved likelihood of BU remission across all induction (risk ratio 1.77, 95% confidence interval 1.51-2.08) and maintenance (risk ratio 2.40, 95% confidence interval 1.54-3.73) therapies, compared to placebo, with no major differences amongst the anti-interleukin-23 agents (Risankizumab, Mirikizumab and Guselkumab) and JAK-inhibitor therapy (Upadacitinib). Conclusions The advanced IBD therapies studied produce rapid and sustained improvement in bowel urgency remission across mechanisms of action. The degree of bowel urgency improvement was similar between agents, potentially due to their action on similar inflammatory pathways. Areas for future research include investigation of bowel urgency outcomes with other IBD therapies, exploration of underlying mechanisms of action and greater standardization for measuring bowel urgency through validated scores. Funding Agencies None

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