ArticleWorld journal of gastrointestinal pharmacology and therapeutics2026
Clinical outcomes of upadacitinib dose escalation in inflammatory bowel disease: A single-center retrospective cohort study.
Article in World journal of gastrointestinal pharmacology and therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Letter to the Editor: Can upadacitinib dose escalation redefine treatment strategies in refractory inflammatory bowel disease?World journal of gastrointestinal pharmacology and therapeutics · 2026Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundUpadacitinib is a selective Janus kinase-1 (JAK1) inhibitor approved for the treatment of moderate-to-severe ulcerative colitis (UC) and Crohn's disease (CD). Standard therapy consists of induction dosing at 45 mg daily followed by maintenance dosing of 15-30 mg daily. Although pivotal trials demonstrated sustained efficacy with maintenance therapy, secondary loss of response occurs in clinical practice. Data regarding the effectiveness of dose re-escalation remain limited.
aimTo evaluate clinical outcomes following upadacitinib dose escalation in inflammatory bowel disease (IBD) with loss of response to maintenance dosing.
methodsWe conducted a single-center retrospective cohort study of adults with IBD who underwent re-escalation to upadacitinib 45 mg daily beyond the labeled induction period. Data were obtained through electronic medical record review. The primary endpoint was clinical response, defined as provider-documented symptom improvement and/or objective improvement in biomarkers or endoscopic assessment. Secondary outcomes included indications for escalation, corticosteroid exposure, IBD-related healthcare utilization, and treatment durability.
resultsA total of 56 patients were included [38 CD, 18 UC; median age 34 years (interquartile range: 26-46), 43% female] with a mean of 2.49 prior biologic exposures. Among 49 patients with paired symptom data, abdominal pain decreased from 57% to 29% (
conclusionIn this single-center cohort, upadacitinib dose escalation improves symptoms and reduces corticosteroid use, supporting dose intensification as a pragmatic strategy for secondary loss of response.
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