Related Experiment Video

Updated: Oct 19, 2025

Scaled-Up Preparation of an Intermediate of Upatinib, ACT051-3
08:36

Scaled-Up Preparation of an Intermediate of Upatinib, ACT051-3

Published on: April 7, 2023

1.3K

Comparative Efficacy and Tolerability of Janus Kinase Inhibitor Therapies for Moderate to Severe Crohn's Disease: Α

Theodoros Rokkas1, Konstantinos Ekmektzoglou2, Yaron Niv3

  • 1Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece; Medical School, European University of Cyprus, Nicosia, Cyprus. sakkor@otenet.gr.

Journal of Gastrointestinal and Liver Diseases : JGLD
|September 22, 2021
PubMed
Abstract

Insights

Network meta-analysis compared Janus kinase (JAK) inhibitors for Crohn's disease (CD). Upadacitinib and filgotinib showed the best efficacy and tolerability for moderate to severe CD patients.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Trials

Background:

  • Crohn's disease (CD) is a chronic inflammatory bowel disease.
  • Janus kinase (JAK) inhibitors are emerging treatments for moderate to severe CD.
  • Comparative data on JAK inhibitor efficacy and tolerability is limited.

Purpose of the Study:

  • To conduct a network meta-analysis (NWM) comparing the efficacy and tolerability of different JAK inhibitors.
  • To determine the optimal dosing and ranking of JAK inhibitors for treating moderate to severe CD.

Main Methods:

  • A systematic search of PubMed, EMBASE, and Cochrane Library databases was conducted for relevant randomized control trials (RCTs) up to March 2021.
  • A Bayesian network meta-analysis (NWM) was performed to compare tofacitinib, filgotinib, and upadacitinib.
  • Efficacy and tolerability were assessed using Surfaces Under Cumulative Ranking (SUCRA) values.

Main Results:

  • Four RCTs involving 811 patients were included in the NWM.
  • Upadacitinib (6 mg BID and 24 mg BID) and filgotinib (200 OD) demonstrated superior performance compared to placebo and other JAK inhibitor doses.
  • SUCRA values indicated high efficacy for upadacitinib 6 mg BID (96.7%), upadacitinib 24 mg BID (84.6%), and filgotinib 200 OD (78.7%).

Conclusions:

  • Upadacitinib (6 mg BID, 24 mg BID) and filgotinib (200 OD) are effective induction therapies for moderate to severe Crohn's disease.
  • These JAK inhibitor regimens warrant further investigation in well-designed clinical trials.
  • The findings provide valuable comparative insights for clinicians managing CD patients.

More Related Videos

Multimodal Quantitative Phase Imaging with Digital Holographic Microscopy Accurately Assesses Intestinal Inflammation and Epithelial Wound Healing07:38

Multimodal Quantitative Phase Imaging with Digital Holographic Microscopy Accurately Assesses Intestinal Inflammation and Epithelial Wound Healing

Published on: September 13, 2016

8.5K
Dynamic Adhesion Assay for the Functional Analysis of Anti-adhesion Therapies in Inflammatory Bowel Disease08:27

Dynamic Adhesion Assay for the Functional Analysis of Anti-adhesion Therapies in Inflammatory Bowel Disease

Published on: September 20, 2018

7.8K

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
259
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
287
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
240
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
242
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
467
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
270