Upadacitinib Monotherapy After Tofacitinib Failure Was Successful for Induction But Not Maintenance of Remission in Medically Refractory Ulcerative Colitis

This small case series represents real-world experience of the efficacy of upadacitinib after prior tofacitinib failure in medically refractory ulcerative colitis and challenges current observations that upadacitinib is effective after tofacitinib exposure. Although all patients had a clinical or partial response after upadacitinib induction, 4/4 (100%) patients relapsed or required rescue therapy during maintenance, in contrast to previous publications.