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Upadacitinib is Associated With Better Clinical and Biochemical Outcomes Than Tofacitinib in Refractory, Moderate-to-severe Ulcerative Colitis

  • 0Center for Gastroenterology, Department of Internal Medicine, University of Szeged, Szeged, Hungary; HCEMM-USZ Translational Colorectal Research Group, Szeged, Hungary.
Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association +

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September 11, 2025

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September 11, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Upadacitinib (UPA) showed better short- and mid-term effectiveness than tofacitinib (TOFA) for moderate-to-severe ulcerative colitis (UC). UPA demonstrated higher rates of corticosteroid-free remission and clinical remission in bio-experienced patients.

Area Of Science

  • Gastroenterology
  • Immunology
  • Pharmacology

Background

  • Comparative effectiveness data for tofacitinib (TOFA) and upadacitinib (UPA) in ulcerative colitis (UC) are limited.
  • This study focuses on bio-experienced patients with moderate-to-severe UC.

Purpose Of The Study

  • To compare the short- and mid-term effectiveness of TOFA and UPA in UC patients.
  • To evaluate clinical and biochemical remission rates in patients receiving either TOFA or UPA.

Main Methods

  • Retrospective, multicenter cohort study.
  • Inverse probability weighting analysis was used to adjust for baseline characteristics.
  • Coprimary outcomes included corticosteroid-free remission (CSFR) at weeks 12 and 24, and clinical remission (CR) and biochemical remission within 6 months.

Main Results

  • Upadacitinib (UPA) was associated with significantly higher odds of achieving CSFR at weeks 12 and 24 compared to tofacitinib (TOFA).
  • UPA also showed approximately 2-fold higher odds of achieving CR and biochemical remission within 6 months compared to TOFA.
  • No significant differences were observed in IBD-related hospitalization or colectomy rates; no new safety signals were identified.

Conclusions

  • Upadacitinib (UPA) may offer superior short- and mid-term clinical and biochemical outcomes compared to tofacitinib (TOFA) in refractory, moderate-to-severe UC.
  • These findings suggest UPA as a potentially more effective treatment option for this patient population.

Keywords:

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