Patel Perseus V, Rigmaiden Martina, Goyal Alka, Bensen Rachel, Bass Dorsey, Moses Jonathan, Rosen Michael J, Colman Ruben J
Division of Pediatric Gastroenterology, Department of Pediatrics, Stanford Medicine Children's Health, Center for IBD and Celiac Disease, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
Children (Basel). 2025 Mar 22;12(4):401. doi: 10.3390/children12040401.
: In adolescent patients with ulcerative colitis refractory to anti-tumor necrosis factor (TNF) therapy, episodes of acute severe ulcerative colitis (ASUC) require hospitalization or surgery. Upadacitinib can be a potential colectomy-sparing agent in adult ASUC patients receiving intensified dosing. : This case series evaluates clinical outcomes of intensified rescue upadacitinib dosing in adolescent patients with ASUC. We included adolescents admitted with anti-TNF refractory ASUC treated with 30 mg twice daily upadacitinib. The primary outcome was the proportion of patients who remained colectomy-free at the most recent follow-up. : Five patients (aged 14-18) exhibited varying responses to upadacitinib; 2 responded rapidly, while 3 had partial response. All the patients remained on upadacitinib and were colectomy-free during follow-up (55-203 days). Three (60%) ultimately received dual advanced therapy with ustekinumab and upadacitinib. At most recent follow-up, 60% were in clinical/biochemical remission without corticosteroids. : In select cases, intensified upadacitinib may be a potential colectomy-sparing option for adolescent ASUC patients refractory to anti-TNF therapy.
在对抗肿瘤坏死因子（TNF）治疗难治的青少年溃疡性结肠炎患者中，急性重度溃疡性结肠炎（ASUC）发作需要住院或手术。对于接受强化给药的成年ASUC患者，乌帕替尼可能是一种潜在的避免结肠切除术的药物。：本病例系列评估了强化挽救性使用乌帕替尼治疗青少年ASUC患者的临床结局。我们纳入了因抗TNF难治性ASUC入院且接受每日两次30mg乌帕替尼治疗的青少年患者。主要结局是在最近一次随访时仍未进行结肠切除术的患者比例。：五名患者（年龄14 - 18岁）对乌帕替尼表现出不同反应；2名患者反应迅速，3名患者部分缓解。所有患者在随访期间（55 - 203天）持续使用乌帕替尼且未进行结肠切除术。三名患者（60%）最终接受了优特克单抗和乌帕替尼的双重强化治疗。在最近一次随访时，60%的患者在未使用皮质类固醇的情况下处于临床/生化缓解状态。：在某些情况下，强化使用乌帕替尼可能是对抗TNF治疗难治的青少年ASUC患者避免结肠切除术的一种潜在选择。
