RT Journal Article
SR Electronic
T1 Real-world effectiveness of upadacitinib in Crohn’s disease: a UK multicentre retrospective cohort study
JF Frontline Gastroenterology
JO Frontline Gastroenterol
FD BMJ Publishing Group Ltd
SP 297
OP 304
DO 10.1136/flgastro-2024-102668
VO 15
IS 4
A1 Elford, Alexander Thomas
A1 Bishara, Maria
A1 Plevris, Nikolas
A1 Gros, Beatriz
A1 Constantine-Cooke, Nathan
A1 Goodhand, James
A1 Kennedy, Nicholas A
A1 Ahmad, Tariq
A1 Lees, Charlie W
YR 2024
UL http://fg.bmj.com/content/15/4/297.abstract
AB Background Upadacitinib is a Janus kinase inhibitor, which has recently been approved for treating Crohn’s disease. There are limited real-world studies on the outcomes of upadacitinib in Crohn’s disease.Objective Our aim was to evaluate the outcomes of upadacitinib in a real-world Crohn’s disease cohort.Methods We conducted a retrospective, multicentre, cohort study over a 2-year period across National Health Service (NHS) Lothian and Royal Devon University Healthcare NHS Foundation Trust. The primary outcome was treatment persistence at week 24. Secondary endpoints were corticosteroid-free clinical remission (Harvey-Bradshaw Index (HBI)<5) and biomarker remission (C-reactive protein (CRP)≤5 mg/L and faecal calprotectin (FCAL)<250 µg/g) at 12, 24 and 52 weeks. We recorded adverse events.Results 135 patients commenced upadacitinib as of the 1 January 2024, of which 93 patients with active Crohn’s disease were included with a minimum of 12 weeks follow-up. The median follow-up time was 25 weeks (IQR 15–42 weeks). 82% of the cohort had exposure to at least two classes of advanced therapies, and 52% had exposure to at least three classes of advanced therapies. Treatment persistence was 87.1% at week 12, 81.7% at week 24 and 62.8% at week 52. Rates of clinical remission were 64% (42/66), 48% (22/46) and 38% (8/21) at weeks 12, 24 and 52, respectively. Significant reductions in HBI, CRP and FCAL were observed during follow-up. 14% (13/91) had a hospitalisation due to Crohn’s disease. Adverse events occurred in 40% (37/93) of the cohort, of which 12% (11/93) were serious.Conclusion Upadacitinib was effective in a real-world, highly refractory, Crohn’s disease cohort with good persistence.Data are available on reasonable request.