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Upadacitinib induction is effective and safe in ulcerative colitis patients including those with prior exposure to

Robert Gilmore1,2, Richard Fernandes1,2, Imogen Hartley3

  • 1Department of Gastroenterology, Mater Hospital, Brisbane, Australia.

Intestinal Research
|December 22, 2024
PubMed
Abstract

Insights

Upadacitinib effectively treats ulcerative colitis, achieving high clinical remission rates in real-world use. It is also effective in patients previously treated with tofacitinib.

Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Upadacitinib is a selective Janus kinase inhibitor approved for ulcerative colitis treatment.
  • Clinical trials often exclude diverse patient subgroups, limiting real-world effectiveness data.
  • This study evaluates upadacitinib outcomes in a real-world ulcerative colitis population.

Purpose of the Study:

  • To assess the real-world effectiveness and outcomes of upadacitinib in patients with ulcerative colitis.
  • To compare upadacitinib efficacy in tofacitinib-experienced versus tofacitinib-naïve patients.
  • To evaluate transmural healing using intestinal ultrasound.

Main Methods:

  • Retrospective analysis of 152 patients with moderate-to-severe ulcerative colitis treated with upadacitinib across 13 Australian centers.
  • Data collected at baseline, week 8, and week 16, including clinical, biochemical, endoscopic, and intestinal ultrasound outcomes.
  • Comparison of remission rates between tofacitinib-experienced and -naïve groups.

Main Results:

  • High clinical remission rates observed: 79% at week 8 and 84% at week 16.
  • No significant difference in week 16 remission between tofacitinib-experienced (86%) and -naïve (84%) patients.
  • Intestinal ultrasound showed significant transmural remission (64% at week 8, 81% at week 16) with reduced bowel wall thickness.

Conclusions:

  • Upadacitinib demonstrates high clinical remission rates in a real-world ulcerative colitis cohort.
  • Upadacitinib is effective in patients with prior tofacitinib exposure.
  • Intestinal ultrasound confirms significant and sustained transmural remission.
Keywords:
Intestinal ultrasoundJanus kinase inhibitorsTofacitinibUlcerative colitisUpadacitinib

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