{
  "abstract": "Background: Acute severe active ulcerative colitis (ASUC) often requires rescue therapy when standard medical treatment fails. Data on the use of upadacitinib (UPA) as a rescue option after failure of steroids and infliximab (IFX) and on the long-term outcomes of UPA treatment up to 48 weeks, remain scarce.\n\nMethods: We evaluated hospitalized patients with ASUC (Truelove and Witts criteria) who received UPA following the failure of intravenous corticosteroids (IV-CS) and IFX. Outcomes included UPA persistence, clinical remission (CR), partial Mayo score (pMAYO) ≤ 2, clinical response (≥3-point reduction in pMAYO), and colectomy rates over 48 weeks of follow-up.\n\nResults: Fifty patients with ASUC from 11 centers (male, 54%) received UPA treatment following IV-CS/IFX failure. Prior IFX exposure was 86%, and > 50% of the patients had received ≥ 2 biologics. Continuation was 52% overall (week 4, 90%; week 48, 52%). Discontinuation was due to primary nonresponse (42%), secondary loss of response (46%), or other causes (13%). Adverse events related to UPA occurred in 24% of patients and almost all were nonsevere. Stool frequency, rectal bleeding, pMayo score, and C-reactive protein (CRP) improved rapidly by week 1 and were thereafter maintained to week 48. Colectomy occurred in 22% of patients (nearly half of them in week 1). Week 1 CRs were 60%/30% while the week 48 CR rate was 51%. Higher baseline CRP predicted colectomy; no factor affected UPA persistence.\n\nConclusion: In this multicenter cohort of patients with ASUC who failed IV-CS and IFX rescue, third-line UPA was associated with a low colectomy rate and sustained response up to 1 year, with an acceptable safety profile. UPA may provide sufficient disease control to prevent or delay colectomy, or to serve as a bridge to alternative therapies.\n\nSummary: In this retrospective multicenter cohort (11 centers), 50 patients with severe ulcerative colitis refractory to intravenous corticosteroids and infliximab received upadacitinib. Improved symptoms and C-reactive protein (CRP) levels occurred by week 1 and persisted to week 48; colectomy occurred in 22% and adverse events in 24% of patients.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 25,
  "authors": [
    {
      "name": "Nalan Gülşen Ünal"
    },
    {
      "name": "Oğuz Kağan Bakkaloğlu",
      "orcid": "0000-0001-8661-5791"
    },
    {
      "name": "Taylan Kav"
    },
    {
      "name": "Tuğçe Eşkazan"
    },
    {
      "name": "Haluk Tarık Kani"
    },
    {
      "name": "Atilla Akpınar"
    },
    {
      "name": "Pırıl Akıncıoğlu"
    },
    {
      "name": "Gizem Dağcı"
    },
    {
      "name": "İbrahim Şendur"
    },
    {
      "name": "İlker Büyüktorun"
    },
    {
      "name": "Sezgin Barutçu"
    },
    {
      "name": "Güner Kılıç"
    },
    {
      "name": "Göksel Bengi"
    },
    {
      "name": "Bilger Çavuş"
    },
    {
      "name": "Nevin Oruç"
    },
    {
      "name": "Yeşim Özen Alahdab"
    },
    {
      "name": "Özlen Atuğ"
    },
    {
      "name": "Dinç Dinçer"
    },
    {
      "name": "Tarkan Karakan"
    },
    {
      "name": "Ali İbrahim Hatemi"
    },
    {
      "name": "Yusuf Ziya Erzin"
    },
    {
      "name": "Ahmet Tezel"
    },
    {
      "name": "Murat Törüner"
    },
    {
      "name": "Filiz Akyüz"
    },
    {
      "name": "Aykut Ferhat Çelik"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6sjby84kakrcg.bib",
  "cited_by": 0,
  "doi": "10.1093/ibd/izag126",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13722122/",
  "id": "6sjby84kakrcg",
  "issns": [
    "1078-0998",
    "1536-4844"
  ],
  "landing_url": "https://doi.org/10.1093/ibd/izag126",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00260"
    ],
    [
      "heading",
      "Editor's Choice"
    ],
    [
      "heading",
      "Leading Off"
    ],
    [
      "openalex",
      "1311|Inflammatory Bowel Disease"
    ]
  ],
  "openalex": "W7170071149",
  "pdf_url": null,
  "pmcid": "PMC13722122",
  "pmid": "42485228",
  "published": "2026-07-22",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/6sjby84kakrcg.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T12:22:41Z",
      "native_id": "PMC13722122",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ibd/izag126"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|Inflammatory Bowel Disease",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "Upadacitinib as a rescue therapy for steroid- and infliximab-refractory acute severe ulcerative colitis: short- and long-term effectiveness and safety in a multicenter cohort study",
  "title_text": "Upadacitinib as a rescue therapy for steroid- and infliximab-refractory acute severe ulcerative colitis: short- and long-term effectiveness and safety in a multicenter cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:41Z",
  "url": "https://research.draconitic.com/paper/6sjby84kakrcg",
  "venue": "Inflammatory Bowel Diseases",
  "versions": []
}