Background and aims: 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. Methods: 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). Results: 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%) (
Sequencing JAK-inhibitors in ulcerative colitis: effectiveness and safety of switching within treatment class / T. Innocenti, J. Hanžel, M. Truyens, M. Lukaš, H. Gordon, A. Cremer, T. Molnár, M. Julsgaard, S. Onali, A. Todeschini, O.M. Nardone, N.M. Noor, F. Caprioli, F. Scaldaferri, K. Argyriou, E.V. Savarino, M. Brinar, C.R.H. Hedin, M. Vela González, A. Armuzzi, A. Blesl, A. Aratari, A. Quadarella, T.L. Parigi, L. Bertani, C. Ferracane, M. Uzzan, G. Michalopoulos, A. De Bernardi, K. Katsanos, P. Balestrieri, G. Piñero, K. Karmiris, A.G. Casbas, S. Nikolic, C. Felice, D. Pugliese, P. Pastras, G. Mocci, L. Pouillon, G.J. Mantzaris, L. Ramos, M.J. Casanova, I.E. Koutroubakis, M.J. García, N. Null, L. Bonacci, E. Bonazzi, P. Bossuyt, C. Bezzio, C.C. De Castro Gonçalves, M. Chaparro, T. Christos, A. Curto, S. Danese, B. Farkas, A. Favale, S. Festa, K. Foteinogiannopoulou, F. Fousekis, A. Kapsoritakis, Ž. Krznarić, L. Laterza, C. Liefferinckx, M. Mañosa, D. Noviello, L. Parisio, S. Saibeni, M.T. Sharip, E. Tettoni, T. Lobaton, G. Dragoni. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1876-4479. - (2025), pp. jjaf188.1-jjaf188.27. [Epub ahead of print] [10.1093/ecco-jcc/jjaf188]
Sequencing JAK-inhibitors in ulcerative colitis: effectiveness and safety of switching within treatment class
F. Caprioli;D. Noviello;
2025
Abstract
Background and aims: 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. Methods: 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). Results: 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%) (
| File | Dimensione | Formato | |
|---|---|---|---|
|
jjaf188.pdf
embargo fino al 01/12/2026
Tipologia:
Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Licenza:
Creative commons
Dimensione
1.21 MB
Formato
Adobe PDF
|
1.21 MB | Adobe PDF | Visualizza/Apri Richiedi una copia |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
