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 / Innocenti, Tommaso; Hanžel, Jurij; Truyens, Marie; Lukaš, Milan; Gordon, Hannah; Cremer, Anneline; Molnár, Tamás; Julsgaard, Mette; Onali, Sara; Todeschini, Alessia; Nardone, Olga Maria; Noor, Nurulamin M; Caprioli, Flavio; Scaldaferri, Franco; Argyriou, Konstantinos; Savarino, Edoardo Vincenzo; Brinar, Marko; Hedin, Charlotte R H; Vela González, Milagros; Armuzzi, Alessandro; Blesl, Andreas; Aratari, Annalisa; Quadarella, Alessandro; Parigi, Tommaso Lorenzo; Bertani, Lorenzo; Ferracane, Concetta; Uzzan, Mathieu; Michalopoulos, George; De Bernardi, Alice; Katsanos, Konstantinos; Balestrieri, Paola; Piñero, Gisela; Karmiris, Konstantinos; Casbas, Ana Gutierrez; Nikolic, Sara; Felice, Carla; Pugliese, Daniela; Pastras, Ploutarchos; Mocci, Giammarco; Pouillon, Lieven; Mantzaris, Gerassimos J; Ramos, Laura; Casanova, María José; Koutroubakis, Ioannis E; García, María José; Lobaton, Triana; Dragoni, Gabriele. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - ELETTRONICO. - (2025), pp. 0-0. [10.1093/ecco-jcc/jjaf188]
Sequencing JAK-inhibitors in ulcerative colitis: effectiveness and safety of switching within treatment class
Innocenti, Tommaso;Dragoni, Gabriele
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%) (
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