Anita Afzali, a physician-researcher at the University of Cincinnati, has published landmark data showing that guselkumab, a biologic therapy for Crohn's disease, sustains remission in nearly all patients over a five-year period—the longest follow-up ever reported for this class of drug. The study, published May 1, 2026, in Inflammatory Bowel Diseases, represents a significant advance in treating a disease that affects approximately 780,000 Americans and carries a high lifetime risk of surgery.
Crohn's disease is a chronic, progressive inflammatory condition with no cure, making sustained remission a rare and precious outcome. Afzali, who holds the James F. Heady endowed chair and serves as interim chair of the Department of Internal Medicine at UC's College of Medicine, led the Phase 2 GALAXI 1 long-term extension study, which tracked patients with moderately to severely active disease—including those who had already failed conventional and biologic therapies. These are among the most difficult-to-treat patients in gastroenterology.
The results are striking. At five years, 97.7% of patients who remained on guselkumab achieved clinical remission, and crucially, all of those patients were corticosteroid-free, meaning they no longer needed systemic steroids to manage their disease. Even more compelling, over 71% achieved endoscopic response and more than 51% achieved endoscopic remission—objective evidence of actual healing of the intestinal lining visible on examination. These endoscopic markers are strongly associated with long-term outcomes and reduced surgery risk.
Guselkumab, marketed as Tremfya by Johnson & Johnson, works as a selective, dual-acting IL-23 p19 inhibitor—part of a newer generation of precision therapies that target specific immune pathways rather than broadly suppressing the entire immune system. What distinguishes this data is that the benefits held across the full spectrum of patients, regardless of whether they had previously failed other biologic drugs. This breadth of effectiveness across what are typically treatment-refractory populations signals genuine therapeutic advance.
The safety profile remained consistent with findings from earlier studies, with no new safety signals emerging during the five-year follow-up period. In chronic disease management, long-term safety is as important as efficacy, and the stability of this profile across years is noteworthy.
Afzali's role extends far beyond leading individual trials. She has been the lead author and global scientific investigator throughout the entire guselkumab development program—from induction results published in Gastroenterology in 2022, through maintenance findings in The Lancet Gastroenterology & Hepatology in 2024, to Phase 3 confirmatory studies published in The Lancet in 2025. This rare continuity of leadership across a drug's full development trajectory underscores the depth of her scientific stewardship and signals confidence in the consistency and rigor of the program.
Beyond individual trials, Afzali has also founded the Inflammation & Immunology Research Consortium at UC, a multidisciplinary initiative designed to accelerate discovery and translation across immune-mediated diseases. Her vision extends to integrating clinical operations, research, and innovation across the health system to create truly patient-centered translational care models. For Crohn's disease patients, these five-year durability data represent more than statistics—they represent the possibility of moving beyond symptom management toward actual long-term disease control and the possibility of a life without constant medication adjustments or surgery.