Sequencing JAK-inhibitors in ulcerative colitis: effectiveness and safety of switching within treatment class
Year: 2025
Type: article
Study design: Observational Study
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 multicenter 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 (odds ratio [OR] = 1.92, 95% confidence interval [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%) ( Conclusion Treatment with a second JAKi is effective and safe in patients with UC already exposed to JAKi. Primary failure to a first JAKi and steroid use at initiation of the second JAKi might reduce the likelihood of success with the second JAKi.
Source: Journal of Crohn s and Colitis
Authors: Tommaso Innocenti, Jurij Hanžel, Marie Truyens, Milan Lukaš, Hannah Gordon, Anneline Cremer, Tamás Molnár, Mette Julsgaard, Sara Onali, Alessia Todeschini, Olga Maria Nardone, Nurulamin M Noor, Flavio Caprioli, Franco Scaldaferri, Konstantinos Argyriou, Edoardo Vincenzo Savarino, Marko Brinar, Charlotte R H Hedin, Milagros Vela González, Alessandro Armuzzi, Andreas Blesl, Annalisa Aratari, Alessandro Quadarella, Tommaso Lorenzo Parigi, Lorenzo Bertani, Concetta Ferracane, Mathieu Uzzan, George Michalopoulos, Alice De Bernardi, Konstantinos Katsanos, Paola Balestrieri, Gisela Piñero, Konstantinos Karmiris, Ana Gutierrez Casbas, Sara Nikolic, Carla Felice, Daniela Pugliese, Ploutarchos Pastras, Giammarco Mocci, Lieven Pouillon, Gerassimos J Mantzaris, Laura Ramos, María José Casanova, Ioannis E Koutroubakis, María José García, Triana Lobaton, Gabriele Dragoni, The JAKi-SEQ Study Group
Institutions: Azienda Ospedaliero-Universitaria Careggi, University of Florence, Ljubljana University Medical Centre, Ghent University Hospital, Ghent University, Iscare I.V.F, John Radcliffe Hospital, University of Oxford, Oxford University Hospitals NHS Trust, Erasmus Hospital, University of Szeged, Aarhus University, Aarhus University Hospital, University of Cagliari, Ospedale Sacro Cuore Don Calabria, University of Naples Federico II, Cambridge University Hospitals NHS Foundation Trust, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, University Hospital of Larissa, University of Padua, University Hospital Centre Zagreb, Karolinska University Hospital, Karolinska Institutet, Hospital Universitario Nuestra Señora de Candelaria, Humanitas University, IRCCS Humanitas Research Hospital, Medical University of Graz, ASL Roma, Ospedale San Filippo Neri, Fondazione Poliambulanza Istituto Ospedaliero, IRCCS Ospedale San Raffaele, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, General Hospital of Athens G. Genimatas, Aziende Socio Sanitaria Territoriale Rhodense, University of Ioannina, Campus Bio Medico University Hospital, Hospital Universitari Germans Trias i Pujol, The General Hospital of Heraklion "Venizeleio-Pananio", Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital General Universitario de Alicante Doctor Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), University of Maribor, University of Patras, General University Hospital of Patras, Azienda Ospedaliera G. Brotzu, Imelda Hospital, Hospital Universitario de Canarias, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, University Hospital of Heraklion, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W4415830664