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. 2025 Jul 14;17(7):e87903.
doi: 10.7759/cureus.87903. eCollection 2025 Jul.

Real-World Efficacy of Upadacitinib in Patients With Ulcerative Colitis

Abdul Ghaffar  1 , Fraz Ahmad  2 , Joseph Collum  1 , Linta Naveed  3
Affiliations

Real-World Efficacy of Upadacitinib in Patients With Ulcerative Colitis

Abdul Ghaffar et al. Cureus. .

Abstract

Upadacitinib (UPA) is a selective JAK-1 inhibitor used in the treatment of ulcerative colitis (UC) and Crohn's disease. We report a real-world retrospective study evaluating the efficacy and safety of UPA in 17 patients who scaled from mild to severe UC, and demonstrated significant improvement in Inflammatory biomarkers, with the majority (16/17 patients) achieving reduced fecal calprotectin levels. Three patients had subsequent endoscopic evaluation after being initiated on UPA; two showed improvement in the Mayo score, and the remaining patient remained static. The side effect profile was consistent with known JAK inhibitor effects, with elevated cholesterol as the most common adverse event, and one case of neutropenia was observed. These findings suggest that UPA is an effective therapeutic option for refractory UC patients, and further studies would help in confirming its long-term efficacy in these patients.

Keywords: crohn's disease; fecal calprotectin; inflammatory bowel disease; jak inhibitor; mayo score; ulcerative colitis; upadacitinib.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: Dr. Fraz Ahmad and Dr. Linta Naveed have a personal relationship. This has been disclosed in accordance with ICMJE guidelines and institutional policies. The relationship has not influenced the design, analysis, interpretation, or authorship of this manuscript.

Figures

Figure 1
Figure 1. Gender distribution of patients
Figure 2
Figure 2. Distribution of patients as per demographic mapping
Figure 3
Figure 3. Frequency of biologic and immunomodulator treatments prior to being started on upadacitinib
Figure 4
Figure 4. Fecal calprotectin levels before and after treatment with upadacitinib
Figure 5
Figure 5. Overall FCL percentage of improvement among patients
FCL: fecal calprotectin level
Figure 6
Figure 6. Frequency of adverse events among patients
See this image and copyright information in PMC

References

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