Asian Pacific Association of Gastroenterology (APAGE) Clinical Practice Guidelines on the Use of Small Molecules and IL-23 p19 Inhibitors in Ulcerative Colitis and Crohn's Disease
4
Issued Date
2026-01-01
Resource Type
ISSN
08159319
eISSN
14401746
Scopus ID
2-s2.0-105038739855
Journal Title
Journal of Gastroenterology and Hepatology Australia
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Gastroenterology and Hepatology Australia (2026)
Suggested Citation
Ooi C.J., Ling K.L., Limsrivilai J., Wei S.C., Mak J.W.Y., Kobayashi T., Dang L.M., Leong R.W., Lin H., Weng M.T., Ong W.C., Ahuja V., Aniwan S., Hokari R., Lee W.J.J., Leow A.H.R., Leung W.K., Lim W.C., Makharia G., Matsuoka K., Mustaffa N., Ng S.C., Philip M., Pisespongsa P., Ali R.A.R., Ran Z.H., Simadibrata M., Sollano J., Tan M., Viet H.D., Wan Ibrahim N.R., Wu K.C., Ye B.D., Hilmi I. Asian Pacific Association of Gastroenterology (APAGE) Clinical Practice Guidelines on the Use of Small Molecules and IL-23 p19 Inhibitors in Ulcerative Colitis and Crohn's Disease. Journal of Gastroenterology and Hepatology Australia (2026). doi:10.1111/jgh.70379 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116928
Title
Asian Pacific Association of Gastroenterology (APAGE) Clinical Practice Guidelines on the Use of Small Molecules and IL-23 p19 Inhibitors in Ulcerative Colitis and Crohn's Disease
Author(s)
Ooi C.J.
Ling K.L.
Limsrivilai J.
Wei S.C.
Mak J.W.Y.
Kobayashi T.
Dang L.M.
Leong R.W.
Lin H.
Weng M.T.
Ong W.C.
Ahuja V.
Aniwan S.
Hokari R.
Lee W.J.J.
Leow A.H.R.
Leung W.K.
Lim W.C.
Makharia G.
Matsuoka K.
Mustaffa N.
Ng S.C.
Philip M.
Pisespongsa P.
Ali R.A.R.
Ran Z.H.
Simadibrata M.
Sollano J.
Tan M.
Viet H.D.
Wan Ibrahim N.R.
Wu K.C.
Ye B.D.
Hilmi I.
Ling K.L.
Limsrivilai J.
Wei S.C.
Mak J.W.Y.
Kobayashi T.
Dang L.M.
Leong R.W.
Lin H.
Weng M.T.
Ong W.C.
Ahuja V.
Aniwan S.
Hokari R.
Lee W.J.J.
Leow A.H.R.
Leung W.K.
Lim W.C.
Makharia G.
Matsuoka K.
Mustaffa N.
Ng S.C.
Philip M.
Pisespongsa P.
Ali R.A.R.
Ran Z.H.
Simadibrata M.
Sollano J.
Tan M.
Viet H.D.
Wan Ibrahim N.R.
Wu K.C.
Ye B.D.
Hilmi I.
Author's Affiliation
National University of Singapore
Chinese University of Hong Kong
Universiti Malaya
Universiti Kebangsaan Malaysia
Chulalongkorn University
All India Institute of Medical Sciences, New Delhi
National Taiwan University Hospital
Faculty of Medicine and Health
Asan Medical Center
Duke-NUS Medical School
Xijing Hospital
Singapore General Hospital
King Mongkut's Institute of Technology Ladkrabang
The University of Hong Kong Li Ka Shing Faculty of Medicine
Siriraj Hospital
National University Health System
National Defense Medical College Tokorozawa
Sunway University
Tan Tock Seng Hospital
School of Medical Sciences, Universiti Sains Malaysia
Shanghai University of Medicine & Health Sciences
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kementerian Kesihatan Malaysia
Hanoi Medical University
University of Santo Tomas, Manila
Department of Medicine
Toho University Medical Center Sakura Hospital
Kitasato University Kitasato Institute Hospital
Pantai Holdings Sdn Bhd
Lisie Hospital
University of Medicine and Pharmacy
Abdi Waluyo Hospital
Microbiota I-Center (MagIC) Limited
Chinese University of Hong Kong
Universiti Malaya
Universiti Kebangsaan Malaysia
Chulalongkorn University
All India Institute of Medical Sciences, New Delhi
National Taiwan University Hospital
Faculty of Medicine and Health
Asan Medical Center
Duke-NUS Medical School
Xijing Hospital
Singapore General Hospital
King Mongkut's Institute of Technology Ladkrabang
The University of Hong Kong Li Ka Shing Faculty of Medicine
Siriraj Hospital
National University Health System
National Defense Medical College Tokorozawa
Sunway University
Tan Tock Seng Hospital
School of Medical Sciences, Universiti Sains Malaysia
Shanghai University of Medicine & Health Sciences
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kementerian Kesihatan Malaysia
Hanoi Medical University
University of Santo Tomas, Manila
Department of Medicine
Toho University Medical Center Sakura Hospital
Kitasato University Kitasato Institute Hospital
Pantai Holdings Sdn Bhd
Lisie Hospital
University of Medicine and Pharmacy
Abdi Waluyo Hospital
Microbiota I-Center (MagIC) Limited
Corresponding Author(s)
Other Contributor(s)
Abstract
Ulcerative colitis (UC) and Crohn's disease (CD) are increasingly prevalent in the Asia Pacific region, necessitating updated, region-specific guidance on advanced therapies. Targeted small molecule agents, such as filgotinib, tofacitinib, upadacitinib, etrasimod, and ozanimod; and the IL-23 p19 inhibitors (guselkumab, mirikizumab, risankizumab) are the newest advanced therapies in our armamentarium for the treatment of IBD. The aim of the Asia-Pacific consensus statements is to provide context-specific recommendations integrating real-world evidence specific to our region. The Asian-Pacific Association of Gastroenterology (APAGE) Committee on Inflammatory Bowel Disease, with the participation of Asian Education Network in Inflammatory Bowel Disease (AEN-IBD), convened a forum of 34 IBD experts from 12 countries to develop consensus guidelines on the best practices on the use of these new advanced therapies using the modified Delphi method. IL-23 p19 inhibitors have shown good efficacy in biologic-naïve and experienced patients in both UC and CD, with clinical and endoscopic superiority over ustekinumab and an excellent safety profile. JAK inhibitors (tofacitinib and filgotinib) are efficacious in UC, and upadacitinib is efficacious in both UC and CD. They have a rapid time to response, and emerging data on acute severe UC appears promising. However, careful screening and monitoring is needed for known side effects, and prophylactic vaccination for herpes zoster should be considered. S1P modulators (ozanimod, etrasimod) are efficacious in UC with a favorable side effect profile.