TY - JOUR
T1 - Upadacitinib for Induction of Remission in Pediatric Ulcerative Colitis: An International Multicenter Study
AU - Yerushalmy Feler, Anat
AU - Spencer, Elizabeth
AU - Dolinger, Michael
AU - Suskind, David
AU - Mitrova, Katarina
AU - Hradsky, Ondrej
AU - Conrad, Máire
AU - Kelsen, Judith
AU - Uhlig, Holm
AU - Tzivinikos, Christos
AU - Ancona, Silvana
AU - Wlazlo, Magdalena
AU - Hackl, Lukas
AU - Shouval , Dror
AU - Bramuzzo, Matteo
AU - Urlep, Darja
AU - Olbjørn, Christine
AU - D'Arcangelo, Giulia
AU - Pujol-Muncunill, Gemma
AU - Yogev, Dotan
AU - Kang, Ben
AU - Gasparetto, Marco
AU - Rungø , Christine
AU - Kolho, Kaija-Leena
AU - Hojsak, Iva
AU - Norsa, Lorenzo
AU - Rinawi, Firas
AU - Sansotta, Naire
AU - Magen Rimon, Ramit
AU - Granot, Maya
AU - Scarallo, Luca
AU - Trindade, Eunice
AU - Velasco Rodríguez-Belvís, Marta
AU - Turner, Dan
AU - Cohen, Shlomi
PY - 2025/5
Y1 - 2025/5
N2 - Background and Aims: Data on upadacitinib therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBD-U) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as an induction therapy in pediatric UC or IBD-U. Methods: In this multicenter retrospective study, children treated with upadacitinib for induction of remission of active UC or IBD-U from 30 centers worldwide were enrolled. Demographic, clinical, and laboratory data, as well as adverse events (AEs), were recorded at Week 8 post-induction. Results: One hundred children were included (90 UC and 10 IBD-U, median age 15.6 [interquartile range 13.3–17.1] years). Ninety-eight were previously treated with biologic therapies, and 76 were treated with ≥2 biologics. At the end of the 8-week induction period, clinical response, clinical remission, and corticosteroid-free clinical remission (CFR) were observed in 84%, 62%, and 56% of the children, respectively. Normal C-reactive protein and fecal calprotectin (FC) <150 mcg/g were achieved in 75% and 50%, respectively. Combined CFR and FC remission was observed in 18/46 (39%) children with available data at 8 weeks. Adverse events were recorded in 37 children, including 1 serious AE of an appendiceal neuroendocrine tumor. The most frequent AEs were hyperlipidemia (n = 13), acne (n = 12), and infections (n = 10, 5 of whom with herpes viruses). Conclusions: Upadacitinib is an effective induction therapy for refractory pediatric UC and IBD-U. Efficacy should be weighed against the potential risks of AEs.
AB - Background and Aims: Data on upadacitinib therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBD-U) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as an induction therapy in pediatric UC or IBD-U. Methods: In this multicenter retrospective study, children treated with upadacitinib for induction of remission of active UC or IBD-U from 30 centers worldwide were enrolled. Demographic, clinical, and laboratory data, as well as adverse events (AEs), were recorded at Week 8 post-induction. Results: One hundred children were included (90 UC and 10 IBD-U, median age 15.6 [interquartile range 13.3–17.1] years). Ninety-eight were previously treated with biologic therapies, and 76 were treated with ≥2 biologics. At the end of the 8-week induction period, clinical response, clinical remission, and corticosteroid-free clinical remission (CFR) were observed in 84%, 62%, and 56% of the children, respectively. Normal C-reactive protein and fecal calprotectin (FC) <150 mcg/g were achieved in 75% and 50%, respectively. Combined CFR and FC remission was observed in 18/46 (39%) children with available data at 8 weeks. Adverse events were recorded in 37 children, including 1 serious AE of an appendiceal neuroendocrine tumor. The most frequent AEs were hyperlipidemia (n = 13), acne (n = 12), and infections (n = 10, 5 of whom with herpes viruses). Conclusions: Upadacitinib is an effective induction therapy for refractory pediatric UC and IBD-U. Efficacy should be weighed against the potential risks of AEs.
KW - Inflammatory bowel disease
KW - JAK inhibitors
KW - children
UR - https://www.scopus.com/pages/publications/85215665120
U2 - 10.1093/ecco-jcc/jjae182
DO - 10.1093/ecco-jcc/jjae182
M3 - Article
SN - 1873-9946
VL - 20
SP - 1
EP - 8
JO - Journal of Crohn's & Colitis
JF - Journal of Crohn's & Colitis
M1 - 39605286
ER -