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Efficacy of Upadacitinib As a Second-line JAK Inhibitor in Ulcerative Colitis: A Case Series

Shuhei Hosomi1, Yu Nishida1, Yasuhiro Fujiwara1

  • 1Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, Japan.

Internal Medicine (Tokyo, Japan)
|November 26, 2023
PubMed

Insights

Upadacitinib shows promise for ulcerative colitis patients unresponsive to initial Janus kinase (JAK) inhibitors. This JAK1 inhibitor achieved high remission rates in a small case series, suggesting a potential rotation strategy.

Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Janus kinase (JAK) inhibitors are a therapeutic option for UC.
  • Some patients exhibit inadequate response or intolerance to first-line JAK inhibitors like tofacitinib or filgotinib.

Purpose of the Study:

  • To assess the therapeutic impact of upadacitinib in UC patients with prior JAK inhibitor failure.
  • To evaluate upadacitinib as a potential second-line treatment option.

Main Methods:

  • A case series of six UC patients was analyzed.
  • Patients had inadequate response or intolerance to tofacitinib or filgotinib.
  • Treatment with upadacitinib was administered for 2 months.

Main Results:

  • 83.3% (5 out of 6) of patients achieved clinical remission after 2 months.
  • All patients demonstrated reduced C-reactive protein levels.
  • One patient experienced adverse events including COVID-19 pneumonia and elevated transaminases.

Conclusions:

  • Upadacitinib may be an effective treatment for UC patients who failed prior JAK inhibitors.
  • A JAK inhibitor rotation strategy could be beneficial in managing UC.
  • Further research is warranted to confirm efficacy and safety.
Keywords:
JAK inhibitorulcerative colitisupadacitinib

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