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Comparative Efficacy of Janus Kinase Inhibitors (JAKis) for Ulcerative Colitis in Japanese Regional Healthcare

Yuki Itoi1, Yu Hashimoto1, Takashige Masuo2

  • 1Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, JPN.

Cureus
|December 25, 2025
PubMed
Abstract

Insights

Filgotinib demonstrated superior remission rates in ulcerative colitis patients compared to tofacitinib and upadacitinib, particularly in biologic/JAK inhibitor-naïve individuals. This real-world study highlights filgotinib

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Immunology

Background:

  • Ulcerative colitis (UC) treatment landscape includes Janus kinase inhibitors (JAKis).
  • Approved JAKis for UC: tofacitinib (TOF), filgotinib (FIL), and upadacitinib (UPA).
  • Limited real-world comparative data exists for these JAKis in UC.

Purpose of the Study:

  • To compare the efficacy, persistence, and safety of TOF, FIL, and UPA in Japanese UC patients.
  • To assess real-world outcomes of JAKi treatment in UC.

Main Methods:

  • Retrospective analysis of 148 UC treatment sessions (TOF: 60, FIL: 53, UPA: 35).
  • Primary outcome: clinical remission (partial Mayo score ≤1, rectal bleeding score 0).
  • Secondary outcomes: clinical response, steroid-free remission, treatment persistence, and adverse events.

Main Results:

  • At week 24, FIL showed higher remission rates (61%) than TOF (46%) and UPA (41%), a trend continuing at week 48.
  • FIL demonstrated superior remission in both biologic/JAKi-naïve and previously treated patients.
  • Steroid-free remission was more frequent with FIL at weeks 24 and 48.

Conclusions:

  • Filgotinib exhibited favorable remission rates, especially in biologic/JAKi-naïve UC patients.
  • Filgotinib remained effective even after prior JAKi failures, indicating broad applicability.
  • Tofacitinib and upadacitinib showed comparable remission rates in this cohort.
Keywords:
adverse reactionsdrug-related side effectsjanus kinase inhibitorstreatment outcomeulcerative colitis

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