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Upadacitinib Reduces Rates of Hospitalization in Ulcerative Colitis: A Large-Scale Nationwide Cohort Study
Chiaki Maeyashiki1, Nobuharu Tamaki1, Yuki Tanaka1
1Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo 180-8610, Japan.
Journal of Clinical Medicine
|July 28, 2026
Summary
Upadacitinib significantly reduced hospitalizations in ulcerative colitis (UC) patients. This effective treatment option demonstrated sustained benefits up to two years, improving patient outcomes.
Area of Science:
- Gastroenterology and Hepatology
- Clinical Pharmacology
- Immunology
Background:
- Upadacitinib is indicated for moderate-to-severe ulcerative colitis (UC).
- Limited data exist on its long-term effectiveness in large UC patient cohorts.
- This study addresses the need for real-world evidence on upadacitinib's impact.
Purpose of the Study:
- To evaluate the effectiveness and long-term outcomes of upadacitinib in UC patients.
- To assess changes in hospitalization rates before and after upadacitinib initiation.
- To analyze cumulative hospitalization rates up to two years post-initiation.
Main Methods:
- Nationwide, hospital-based cohort study including 2694 UC patients initiating upadacitinib.
- Primary outcome: Comparison of UC-related hospitalization rates in the 1-year periods before and after upadacitinib initiation.
- Secondary outcome: Evaluation of cumulative hospitalization rates up to 2 years.
Main Results:
- Hospitalization rate decreased significantly from 29.3% pre-initiation to 9.6% post-initiation (p < 0.001).
- Cumulative hospitalization rate up to 2 years was 12.6%.
- Adjusted hazard ratio for hospitalization associated with upadacitinib was 0.39 (95% CI: 0.33-0.46, p < 0.001), indicating a substantial reduction.
Conclusions:
- Upadacitinib initiation is associated with significantly reduced hospitalization rates in UC patients.
- This beneficial effect on hospitalization is sustained for up to two years.
- Findings support upadacitinib as an effective treatment option for moderate-to-severe UC.
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