Upadacitinib Salvage Therapy for Infliximab-Experienced Patients with Acute Severe Ulcerative Colitis

• DOI: 10.1093/ecco-jcc/jjad115
• Publication Date: 2023-07-09T10:59:53Z
• Authors: Robert Gilmore; Wei Lian Tan; Richard Fernandes; Yoon-Kyo An; Jakob Begun
• Keywords: Refractory (planetary science); Salvage therapy

Abstract Background and Aims Acute severe ulcerative colitis [ASUC] is a medical emergency treated with intravenous steroids followed by infliximab or cyclosporin in the case of steroid failure emergent colectomy required refractory cases. Case series have reported on effectiveness tofacitinib for disease, but data regarding upadacitinib this setting not been previously reported. We describe use therapy steroid-refractory ASUC patients prior loss response to infliximab. Methods Six who received were identified at two Australian tertiary inflammatory bowel disease centres. Patients up 16 weeks after discharge clinical, biochemical intestinal ultrasound [IUS] outcomes. Results All six demonstrated clinical induction during their inpatient admission. Four achieved corticosteroid-free remission week 8, including complete resolution rectal bleeding transmural healing assessed IUS, sustained 16. One patient proceeded 15 due disease. No adverse events directly attributable identified. Conclusions Upadacitinib may role as safe effective salvage failed respond therapy. Prospective studies are determine safety efficacy before routine can be recommended.