Effectiveness and Safety of a Second JAK Inhibitor in Ulcerative Colitis: The J2J Multicentre Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: While three Janus kinase inhibitors (JAKi) have demonstrated efficacy in ulcerative colitis (UC), scarce data exist regarding JAKi intraclass switching. AIM: To evaluate the effectiveness and safety of a second JAK inhibitor in UC. METHODS: This was a multicentre, retrospective, observational cohort including patients with moderate to severe UC who received a second-line of JAKi after failure or intolerance of a first. The primary outcome was steroid-free clinical remission (SFCR) at Weeks 8-14, defined as a partial Mayo score of 2 or less with no individual sub-score above 1. RESULTS: Among the 169 patients from 28 participating centres, 105 received upadacitinib, 54 filgotinib and 10 tofacitinib as a second-line of JAKi. Overall, 81/169 achieved SFCR at Weeks 8-14: 58/105 with upadacitinib, 18/54 with filgotinib and 5/10 with tofacitinib (p = 0.03). In the multivariate analysis, upadacitinib was independently associated with higher odds of SFCR than filgotinib (OR = 3.15, 95% CI [1.52-6.79]). With a median follow-up duration of 96 days, drug persistence at 6 months was 72.8% with upadacitinib, 57.2% with filgotinib and 66.7% with tofacitinib (p = 0.099). 24.3% of patients (41/169) experienced at least one adverse event leading to treatment withdrawal in 9 patients (5%). No cases of death, cancer, or major acute cardiovascular events were reported. CONCLUSION: A second-line of JAKi provided clinical remission in about half of patients after induction, and was well tolerated.
DOI: 10.1111/apt.70199
Authors: Mathilde Osty, Romain Altwegg, Mélanie Serrero, Alban Benezech, Albane Lecomte, Guillaume Cadiot, Lucine Vuitton, Anne Wampach, Stéphane Nancey, Anthony Buisson, Catherine le Berre, Clea Rouillon, Cyrielle Gilletta, Felix Goutorbe, Mathurin Fumery, Nassim Hammoudi, Ludovic Caillo, Mathias Vidon, Nadia Arab, Gaelle Sickersen, Maryan Cavicchi, Sophie Vieujean, Maeva Charkaoui, Nicolas Richard, Pauline Wils, Bénédicte Caron, Aurélien Amiot, Alexandre Nuzzo, David Laharie, Julien Kirchgesner, Mathieu Uzzan, GETAID‐J2J group
Institutions: Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Hôpital Saint Eloi, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Hôpital Nord, Centre Hospitalier de Valenciennes, Centre Hospitalier Universitaire de Reims, Centre Hospitalier Universitaire de Besançon, Hôpital Européen Georges-Pompidou, Hospices Civils de Lyon, Hôpital Lyon Sud, Centre Hospitalier Universitaire de Clermont-Ferrand, Centre Hospitalier Universitaire de Nantes, Centre Hospitalier Universitaire de Caen Normandie, Hôpital Rangueil, Centre Hospitalier Universitaire Amiens-Picardie, Inserm, Université Paris Cité, Hôpital Saint-Louis, Ecotaxie, Microenvironnement et développement lymphocytaire, Centre Hospitalier Universitaire de Nîmes, Hôpital Intercommunal de Créteil, Centre Hospitalier Universitaire de Nice, Centre Hospitalier Universitaire de Poitiers, Assistance Publique – Hôpitaux de Paris, Centre Hospitalier Universitaire de Liège, CHU Dijon Bourgogne, Centre Hospitalier Universitaire de Rouen, Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau, Université de Rouen Normandie, Université de Lille, Hôpital Claude Huriez, Centre Hospitalier Régional et Universitaire de Nancy, Nutrition-Génétique et Exposition aux Risques Environnementaux, Université de Lorraine, Université Paris-Saclay, Centre de recherche en Epidémiologie et Santé des Populations, Bicêtre Hospital, Hôpital Beaujon, Centre Hospitalier Universitaire de Bordeaux, Hôpital Saint-Antoine
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $5,250
OpenAlex ID: W4410604971