Real-World Effectiveness and Safety of Selective JAK Inhibitors in Ulcerative Colitis and Crohn’s Disease: A Retrospective, Multicentre Study

<b>Background/Objectives</b>: Data on the real-world effectiveness and safety of selective JAK inhibitors (JAKis) in ulcerative colitis (UC) and Crohn's disease (CD) are limited. <b>Methods</b>: We conducted a multicentre, retrospective study to assess clinical, biochemical, and endoscopic outcomes of selective JAKis in bio-experienced UC and CD. <b>Results</b>: A total of 246 patients (mean age: 40.5 ± 14.5 years; 131 UC and 115 CD) were included with a median follow-up of 7.5 months. Among the CD patients receiving upadacitinib (<i>n</i> = 115), 76.2% achieved clinical remission (CR) at week 12. Furthermore, 59.5% of the upadacitinib-treated UC patients (<i>n</i> = 100) experienced CR at week 8. Corticosteroid-free CR (CSFCR) was achieved by 76.9% of the CD patients and 80.6% of the UC patients at week 24, while 50.0% and 36.1% experienced endoscopic remission. At week 52, 66.7% of the CD and 86.2% of the UC patients achieved CSFCR, whereas 54.5% and 52.9% had endoscopic remission. In UC, the effectiveness of upadacitinib was not compromised by prior tofacitinib failure, while the upadacitinib-treated CD patients with stricturing and penetrating disease were less likely to achieve CR by the end of the induction phase (<i>p</i> = 0.04). C-reactive protein (<i>p</i>[CD] < 0.0001; <i>p</i>[UC] < 0.0001) and faecal calprotectin (<i>p</i>[CD] < 0.0001; <i>p</i>[UC] = 0.02) decreased significantly in both patient groups as early as week 2. Among the filgotinib-treated UC patients (<i>n</i> = 31), 28.6% were in CR at week 12. At week 24 and 52, 59.1% and 60% achieved CSFCR, while 0.0% and 20.0% had endoscopic remission. Both C-reactive protein (<i>p</i> = 0.04) and faecal calprotectin (<i>p</i> = 0.04) decreased significantly by week 12. Hyperlipidaemia (9.7-9.8%) was the most common adverse event. <b>Conclusions</b>: Selective JAKis are rapidly effective and safe for treating refractory, moderate-to-severe CD and UC.

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Journal
Journal of Clinical Medicine
Published
2024-12-20
DOI
https://doi.org/10.3390/jcm13247804
Citations
16
Primary Topic
Inflammatory Bowel Disease
Type
article
Field-Weighted Citation Impact
8.81

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article

Real-World Effectiveness and Safety of Selective JAK Inhibitors in Ulcerative Colitis and Crohn’s Disease: A Retrospective, Multicentre Study

Zoltán Szepes, Antonio Rispo, Péter L. Lakatos, A Kagramanova et al.
16 citations
Journal of Clinical Medicine
Inflammatory Bowel Disease
8.81
article

Real-World Effectiveness and Safety of Selective JAK Inhibitors in Ulcerative Colitis and Crohn’s Disease: A Retrospective, Multicentre Study

Zoltán Szepes, Antonio Rispo, Péter L. Lakatos, A Kagramanova, Mohamed Attauabi, Anna Fábián, Milan Lukáš, Emese Ivány, Talat Bessissow, Simone Saibeni, Fabiana Castiglione, Anita Bálint, Rafał Filip, Tamás Resál, Renáta Bor, Alessandro Armuzzi, Péter Bacsúr, Edoardo Vincenzo Savarino, Zsófia Bősze, Jimmy K. Limdi, Giorgos D. Michalopoulos, Klaudia Farkas, Karishma Sethi-Arora, Tamás F. Molnár, B Farkas, Cristina Bezzio, O. V. Knyazev, Eszter Schäfer, Fotios S. Fousekis, Elena Chaskova
article en
16 citations

Abstract

<b>Background/Objectives</b>: Data on the real-world effectiveness and safety of selective JAK inhibitors (JAKis) in ulcerative colitis (UC) and Crohn's disease (CD) are limited. <b>Methods</b>: We conducted a multicentre, retrospective study to assess clinical, biochemical, and endoscopic outcomes of selective JAKis in bio-experienced UC and CD. <b>Results</b>: A total of 246 patients (mean age: 40.5 ± 14.5 years; 131 UC and 115 CD) were included with a median follow-up of 7.5 months. Among the CD patients receiving upadacitinib (<i>n</i> = 115), 76.2% achieved clinical remission (CR) at week 12. Furthermore, 59.5% of the upadacitinib-treated UC patients (<i>n</i> = 100) experienced CR at week 8. Corticosteroid-free CR (CSFCR) was achieved by 76.9% of the CD patients and 80.6% of the UC patients at week 24, while 50.0% and 36.1% experienced endoscopic remission. At week 52, 66.7% of the CD and 86.2% of the UC patients achieved CSFCR, whereas 54.5% and 52.9% had endoscopic remission. In UC, the effectiveness of upadacitinib was not compromised by prior tofacitinib failure, while the upadacitinib-treated CD patients with stricturing and penetrating disease were less likely to achieve CR by the end of the induction phase (<i>p</i> = 0.04). C-reactive protein (<i>p</i>[CD] < 0.0001; <i>p</i>[UC] < 0.0001) and faecal calprotectin (<i>p</i>[CD] < 0.0001; <i>p</i>[UC] = 0.02) decreased significantly in both patient groups as early as week 2. Among the filgotinib-treated UC patients (<i>n</i> = 31), 28.6% were in CR at week 12. At week 24 and 52, 59.1% and 60% achieved CSFCR, while 0.0% and 20.0% had endoscopic remission. Both C-reactive protein (<i>p</i> = 0.04) and faecal calprotectin (<i>p</i> = 0.04) decreased significantly by week 12. Hyperlipidaemia (9.7-9.8%) was the most common adverse event. <b>Conclusions</b>: Selective JAKis are rapidly effective and safe for treating refractory, moderate-to-severe CD and UC.

Journal of Clinical MedicineVol. 13(24)
Semmelweis University (HU), Humanitas University (IT), University of Padua (IT), University of Szeged (HU), McGill University Health Centre (CA), Copenhagen University Hospital (DK), Northern Health and Social Care Trust (GB), Moscow Clinical Scientific Center (RU), State Scientific Center of Coloproctology (RU), General Hospital of Athens G. Genimatas (GR), Irkutsk Regional Clinical Hospital (RU), Scientific Research Institute of Healthcare Organization and Medical Management (RU), Montavid Thermodynamic Research Group (HU), Irkutsk Scientific Center of Surgery and Traumatology (RU), University Hospital of Ioannina (GR), Azienda Ospedale - Università Padova (IT), IRCCS Humanitas Research Hospital (IT), Zrínyi Miklós National Defence University (HU), Aziende Socio Sanitaria Territoriale Rhodense, University of Naples Federico II (IT)
McGill University, McGill University Health Centre, Nemzeti Kutatási, Fejlesztési és Innovaciós Alap, Szent-Györgyi Albert Orvostudományi Kar, Szegedi Tudományegyetem
Good health and well-being
Openalex Percentile: Top 2%
Inflammatory Bowel Disease
8.81
DOIOpen Access PDFOpenAlex
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