Upadacitinib Shows Efficacy in Inducing Remission in Treatment-Resistant IBD
Improvements in Crohn disease and ulcerative colitis at one institution were evident as early as 2 weeks after patients started the novel selective JAK-1 inhibitor upadacitinib, according to study findings published online ahead of print in Clinical Gastroenterology and Hepatology.
“In this large real-world experience in medically-resistant patients with ulcerative colitis and Crohn’s disease, we describe that upadacitinib is rapidly effective and safe, including in those who had prior tofacitinib exposure,” wrote a research team from the University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, Illinois.
The prospective analysis included 105 patients with ulcerative colitis and Crohn disease treated with upadacitinib. Among them, 84 (44 with ulcerative colitis and 40 with Crohn disease) initiated the drug due to active luminal or perianal disease. All patients in the study had previously received antitumor necrosis factor therapy. Some 90% had received two or more advanced therapies.
Among patients with ulcerative colitis, 76.0% achieved clinical response and 69.2% clinical remission at 4 weeks. By 8 weeks, 85.2% achieved clinical response and 81.5% clinical remission, according to the study. Some 77.8% of those previously exposed to tofacitinib achieved clinical remission by 8 weeks.
Among patients with Crohn disease, 76.5% achieved clinical response and 70.6% clinical remission by 8 weeks. Sixty-two percent of patients with elevated fecal calprotectin, and 64% with elevated C-reactive protein, achieved normal levels by week 8.
“Results were seen as early as week 2 in both ulcerative colitis and Crohn’s disease, with clinical remission rates of 36% and 56.3%, respectively,” the team reported. “Acne was the most commonly reported adverse event, occurring in 24/105 patients (22.9%).”
Reference
Friedberg S, Choi D, Hunold T, et al. Upadacitinib is effective and safe in both ulcerative colitis and Crohn’s disease: prospective real-world experience. Clin Gastroenterol Hepatol. Published online March 8, 2023. doi:10.1016/j.cgh.2023.03.001
