The 2026 Digestive Disease Week (DDW) recently concluded in Chicago, Illinois. Every year, DDW is a major global gathering for gastrointestinal and hepatology professionals from around the world. With four days packed with informative sessions and ground-breaking research presentations, there was a deluge of informative research presented at the event..

Today, we’re taking a look at posters presented at DDW 2026 that focus on topics related to ulcerative colitis. Some descriptions and conclusions were edited for clarity and brevity. To view all the posters presented at DDW this year, visit the DDW poster library. 

Ulcerative Colitis Posters from DDW 2026

IL-23 Inhibitors versus Vedolizumab for Biologic Naïve Ulcerative Colitis: A Propensity Matched Outcomes Analysis

  • Description: Both interlukin-23 (IL-23) inhibitors and vedolizumab are increasingly used as first-line advanced therapies for ulcerative colitis. However, no head-to-head comparative data exist for biologic-naïve ulcerative colitis patients. This study compares ulcerative colitis-related outcomes between IL-23 inhibitors and vedolizumab using a large, real-world cohort.
  • Conclusion: In this real-world cohort, treatment of advanced therapy-naïve patients with ulcerative colitis with an IL-23 inhibitor resulted in a lower odds of ulcerative colitis-related adverse outcomes compared to treatment with vedolizumab, while risks of infection were similar. This could indicate more rapid disease control with IL-23 inhibition, reflected by a lower risk of new steroid use.

Developing Patient-Tailored Strategies for Acute Severe Ulcerative Colitis Treatment: Pilot Sequential Multiple Assignment Randomized Trial (SMART)

  • Description: Acute severe ulcerative colitis (ASUC) remains a medical emergency with high rates of colectomy. While infliximab and cyclosporine are established rescue therapies, the optimal positioning of these treatments, upadacitinib, and combinational effects with steroids, remain poorly defined. Furthermore, traditional "one-size-fits-all" approaches to treatment fail to address the dynamic nature of individual patient responses or trajectories during hospitalization. Therefore, we aimed to develop adaptive treatment strategies (ATS), where ASUC treatment is individualized based on how a patient is responding at a given point in time.
  • Conclusion: This pilot SMART demonstrates that patient-tailored ATS that include upadacitinib are feasible and acceptable in patients with ASUC. Preliminary analyses suggest a signal for higher initial response rates with IVCS + UPA 45mg compared to IVCS or UPA 30mg BID alone, with comparable short-term colectomy rates.

Obefazimod Shows First Evidence of Dual Anti-Inflammatory and Anti-Fibrotic Activity in Murine in Vivo and Human in Vitro Models

  • Description: MicroRNA-124 (miR-124) regulates key inflammatory pathways and has been shown to contribute to tissue remodeling. Obefazimod (Obe), an oral small molecule that enhances expression of miR-124, has shown clinical benefit with a favorable safety profile in ulcerative colitis, and is under evaluation in a phase 2b Crohn’s disease (CD) trial (NCT06456593). Persistent intestinal inflammation in inflammatory bowel disease (IBD) can lead to fibrosis and fibrotic remodeling, particularly in CD, where no effective anti-fibrotic therapy is available. MiR-124 is reduced in fibrotic gut tissue and has been linked to the regulation of TGF-β and matrix metalloproteinases (MMPs), which mediate extracellular-matrix turnover. [The researchers] therefore assessed whether Obe-induced miR-124 affects collagen deposition and fibroblast activation.
  • Conclusion: In these first studies, two independent assay systems demonstrated that Obe reduces collagen deposition and fibroblast activation while confirming its established anti-inflammatory activity. These data indicate that Obe may modulate inflammatory and fibrotic pathways. 

Tofacitinib as Monotherapy Following Mesalamine Withdrawal in Ulcerative Colitis Patients in Sustained Remission: Tomo Phase 4 Randomised Study

  • Description: Long-term mesalamine use in ulcerative colitis patients receiving advanced therapies remains common despite limited evidence of additional benefit once remission is achieved. This Phase 4 randomized study evaluated whether mesalamine can be safely discontinued in ulcerative colitis patients in sustained remission on tofacitinib 5 mg twice daily.
  • Conclusion: Ulcerative colitis patients in sustained remission on tofacitinib 5 mg BID may safely discontinue mesalamine without increased risk of relapse or safety concerns. Strategic mesalamine withdrawal may reduce treatment burden and cost without compromising remission durability.

Comparing Diagnostic Accuracy of Transperineal Ultrasound Using Microconvex Probe Versus Conventional Linear Probe to Predict Rectal Histoendoscopic Activity in Ulcerative Colitis (TRIUMPH-UC): A Paired Prospective, Head-to-Head Comparative Study

  • Description: Prior studies have reported variable diagnostic accuracy of transperineal ultrasound in ulcerative colitis using linear and/or microconvex probes. This study directly compared these probes for predicting rectal histoendoscopic activity.
  • Conclusion: In this first head-to-head comparison,the microconvex probe offered measurable diagnostic gains for endoscopic activity but not histology. As the overall area under the curves were modest, either probe alone is insufficient. The adoption of microconvex probes should be guided by availability, experience and clinical context, thereby contributing to ongoing standardisation of transperineal ultrasound in ulcerative colitis.

Real-World Comparative Effectiveness and Safety of Upadacitinib Versus Risankizumab for Ulcerative Colitis

  • Description: The real-world effectiveness and safety of upadacitinib compared to risankizumab for ulcerative colitis is largely unknown.
  • Conclusion: Upadacitinib was associated with significantly higher odds of steroid-free clinical remission at both 12 and 52 weeks compared to risankizumab for ulcerative colitis, however adverse events were more common in patients treated with upadacitinib.

Sign up for alerts and stay informed on the latest published guidelines and articles.