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A JAK1 inhibitor pulls ahead in UC care. A large US real-world study found that upadacitinib was associated with a significantly lower risk of treatment failure compared to five other advanced therapies for ulcerative colitis. Patients on upadacitinib also spent more time in a corticosteroid-free stable state, suggesting it may be a preferred option across the treatment continuum.
A real-world US study analyzing insurance claims data found that upadacitinib (Rinvoq), a JAK1 inhibitor, outperformed five other advanced therapies — infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib — in reducing treatment failure among patients with ulcerative colitis (UC). The study, published in Clinical Gastroenterology and Hepatology, is one of the most comprehensive real-world comparisons of advanced UC therapies to date.
Researchers analyzed over 9,000 treatment episodes from 7,283 patients between 2016 and 2023. Upadacitinib users also spent the greatest proportion of follow-up time in corticosteroid-free disease stability — a meaningful marker of sustained disease control.
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Why it matters: The authors argue that current regulatory restrictions limiting first-line JAK inhibitor use — based on safety data from older rheumatoid arthritis populations — may need revisiting given the growing real-world evidence supporting upadacitinib's effectiveness and safety in UC patients.
