Sequencing JAK-inhibitors in ulcerative colitis effectiveness and safety of switching within treatment class /
Evidence from rheumatology supports a within-class treatment switch for JAK-inhibitors (JAKi), but data in ulcerative colitis (UC) remain limited. We aimed to assess the effectiveness and safety of initiating a second JAKi in patients with UC previously treated with another JAKi.We conducted a multi...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2026
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| Sorozat: | JOURNAL OF CROHNS & COLITIS
20 No. 2 |
| Tárgyszavak: | |
| doi: | 10.1093/ecco-jcc/jjaf188 |
| mtmt: | 36424807 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/39423 |
| Tartalmi kivonat: | Evidence from rheumatology supports a within-class treatment switch for JAK-inhibitors (JAKi), but data in ulcerative colitis (UC) remain limited. We aimed to assess the effectiveness and safety of initiating a second JAKi in patients with UC previously treated with another JAKi.We conducted a multicentre retrospective study, including patients with UC starting a second JAKi after prior JAKi exposure. The primary endpoint was week 12 steroid-free clinical remission (SFCR-rectal bleeding subscore = 0, stool frequency subscore ≤ 1, and no steroids).We included 243 patients [median follow-up: 38 (21-57) weeks]. At weeks 12, 26, and 52, SFCR was achieved in 116/243 (48%), 120/243 (49%), and 69/243 (28%), respectively. Secondary loss of response to the first JAKi was associated with higher SFCR at week 12 compared to primary failure (OR = 1.92, 95%CI = 1.11-3.30, p = 0.02). Higher baseline disease activity (OR = 0.68, 95%CI = 0.68-0.55, p < 0.01) and steroid use (OR = 0.23, 95%CI = 0.13-0.42, p < 0.01) had lower odds of week 12 SFCR. Endoscopic remission occurred in 22/243 (9%) (<week 26) and 27/243 (11%) (26-78 weeks), and endoscopic improvement in 53/243 (22%) and 45/243 (19%), respectively. Sixty-seven (28%) patients discontinued the second JAKi, mostly due to primary (36/67) or secondary failure (22/67). Sixty-six adverse events (mostly acne and infections) occurred in 56 (23%) patients, without major thromboembolic or cardiovascular events.Treatment with a second JAKi is effective and safe in patients with UC already exposed to JAKi. Primary failure to a first JAKi and steroid use at initiation of the second JAKi might reduce the likelihood of success with the second JAKi. |
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| Terjedelem/Fizikai jellemzők: | 12 |
| ISSN: | 1873-9946 |