Guselkumab keeps ulcerative colitis inflammation at bay for nearly 3 years

A long-term extension study presented at the ACG Annual Scientific Meeting found that guselkumab (Tremfya, Johnson & Johnson), a dual-acting IL-23 inhibitor, delivers sustained reductions in intestinal inflammation for patients with moderately to severely active ulcerative colitis (UC) — with benefits lasting up to 144 weeks (nearly 3 years).

Patients who responded to the initial 12-week induction phase showed continued histologic improvement at each follow-up biopsy. By the 144-week mark, the majority of patients who achieved histologic remission after induction remained in remission, and those who started with severe inflammation saw dramatic reductions in disease activity.

By the Numbers:

• ~63–64% of patients showed reduced tissue inflammation after the 12-week induction phase
• 76.6%–83.9% showed improvement at 44 weeks, sustained through 144 weeks (79.6%–83.1%)
• Among patients who entered with severe inflammation (~27%), only 2.3%–3.6% still had severe inflammation at 140 weeks
• 75.9%–81.3% of those who achieved histologic remission post-induction remained in remission at 140 weeks

Why it matters: Histologic healing — not just symptom relief — is increasingly recognized as a meaningful treatment goal in UC. These findings support guselkumab as a durable option that addresses deep tissue-level disease, which may translate to better long-term outcomes for patients.