Kaniewska Magdalena, Lewandowski Konrad, Krogulecki Michał, Filipiuk Aleksandra, Gonciarz Maciej, Pietrzak Anna, Janiak Maria, Adrych Krystian, Klufczynska Agnieszka, Piotrowicz Grażyna, Kopertowska-Majchrzak Maria, Panasiuk Anatol, Mahadea Dagmara, Eder Piotr, Tarasiuk Agnieszka, Rosołowski Mariusz, Talar-Wojnarowska Renata, Małecka-Wojciesko Ewa, Liebert Ariel, Kłopocka Maria, Walecka-Kapica Ewa, Gąsiorowska Anita, Galińska Beata, Leśniakowski Konrad, Zwolińska-Wcisło Małgorzata, Naumowicz Anna, Daniluk Jarosław, Rydzewska Grażyna
Department of Gastroenterology and Internal Medicine, National Medical Institute of the Ministry of the Inferior and Administration, 02-507 Warsaw, Poland.
Department of Gastroenterology, Military Institute of Medicine, 04-141 Warsaw, Poland.
J Clin Med. 2025 Mar 3;14(5):1695. doi: 10.3390/jcm14051695.
Upadacitinib (UPA) is a new oral selective Janus Kinase (JAK) inhibitor that has shown high efficacy in the treatment of ulcerative colitis (UC). We present data from a multicenter real-world study. To assess efficacy of UPA, Total Mayo Score (TMS), fecal calprotectin (FC), endoscopy, and intestinal ultrasonography (IUS) were performed. The study population included 76 patients. An amount of 26.3% of the patients were biologics and small molecules-naive, while 73.7% were exposed. By Week 8, 93.4% of the patients had achieved a clinical response (94.7% naive vs. 92.9% exposed), 72.4% achieved endoscopic improvement (78.9% vs. 71.4%), and 57.9% had clinical remission (78.9% vs. 51.8%). Endoscopic remission was achieved in 31.6% of patients (35.0% vs. 30.4%) and biochemical remission in 82.1% (53.3% vs. 68.3%). All of the results were not significantly different apart from the steroid-free clinical remission-36.8% (68% vs. 26.8%, = 0.002) after 8 weeks of follow-up. IUS was performed in 33 patients. Bowel wall thickness (BWT), inflammatory fat (iFAT), color Doppler signal (CDS), loss of bowel wall stratification (BWS), and Milano Ultrasound Criteria (MUC) had decreased significantly by Weeks 4 and 8 ( < 0.005 for all). Correlation between the IUS results and TMS, FC and endoscopic remission in Week 8 was confirmed ( < 0.001). UPA was well tolerated, and no new safety signals were registered in our group. In this study, UPA was confirmed to be safe and highly effective in inducing remission in UC patients in both the naive group and the biologically exposed patients. The correlation between the IUS results and TMS, FC, and endoscopic remission provides valuable information for clinicians.
乌帕替尼（UPA）是一种新型口服选择性Janus激酶（JAK）抑制剂，已显示出在治疗溃疡性结肠炎（UC）方面具有高效性。我们展示了一项多中心真实世界研究的数据。为评估UPA的疗效，进行了总梅奥评分（TMS）、粪便钙卫蛋白（FC）、内镜检查和肠道超声检查（IUS）。研究人群包括76例患者。26.3%的患者未使用过生物制剂和小分子药物，而73.7%的患者曾使用过。到第8周时，93.4%的患者实现了临床缓解（未使用过生物制剂和小分子药物的患者为94.7%，曾使用过的患者为92.9%），72.4%的患者实现了内镜改善（分别为78.9%和71.4%），57.9%的患者实现了临床缓解（分别为78.9%和51.8%）。31.6%的患者实现了内镜缓解（分别为35.0%和30.4%），82.1%的患者实现了生化缓解（分别为53.3%和68.3%）。除了随访8周后无类固醇临床缓解率外，所有结果均无显著差异（分别为68%和26.8%，P = = 0.002）。对33例患者进行了IUS检查。在第4周和第8周时，肠壁厚度（BWT）、炎性脂肪（iFAT）、彩色多普勒信号（CDS）、肠壁分层消失（BWS）和米兰超声标准（MUC）均显著降低（所有P均< 0.005）。证实了第8周时IUS结果与TMS、FC和内镜缓解之间的相关性（P < 0.001）。UPA耐受性良好，我们组未发现新的安全信号。在本研究中，证实UPA在未使用过生物制剂和小分子药物的患者组以及曾使用过生物制剂的患者中诱导UC患者缓解方面安全且高效。IUS结果与TMS、FC和内镜缓解之间的相关性为临床医生提供了有价值的信息。
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