Upadacitinib用于急性重度溃疡性结肠炎的系统评价
Upadacitinib for Acute Severe Ulcerative Colitis: A Systematic Review
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影响因子:4.3
分区:医学3区 / 胃肠肝病学3区
发表日期:2025 Apr 10
作者:
John A Damianos, Olufemi Osikoya, Gregory Brennan
DOI:
10.1093/ibd/izae191
keywords:
acute severe ulcerative colitis; advanced therapies; small molecules; ulcerative colitis; upadacitinib
摘要
急性重度溃疡性结肠炎（ASUC）仍是临床难题，伴有较高的发病率，包括结肠切除。Upadacitinib（UPA）是一种选择性Janus激酶（JAK）-1抑制剂，已获批用于对肿瘤坏死因子-α抑制剂耐药或不耐受的中重度溃疡性结肠炎患者。此外，近年来其在ASUC中的非标适应症使用也逐渐增加。本文系统回顾了关于UPA在ASUC中的所有相关文献，共纳入11项研究，总计55例患者。大多数患者迅速且持续改善。90天内结肠切除率为16.3%。未接受结肠切除的患者中，80%在随访时处于激素无 remission 状态。报告的不良事件较少，包括2例静脉血栓栓塞事件。总体而言，UPA显示出在ASUC中的安全性和有效性。© 作者（们），2024年。由牛津大学出版社代表克罗恩病与结肠炎基金会出版。所有权利保留。如需商业再利用，请联系reprints@oup.com获取再版和翻译权。其他权限请通过我们网站上的Permissions链接，使用RightsLink服务申请。详细信息请联系journals.permissions@oup.com。
Abstract
Acute severe ulcerative colitis (ASUC) remains a clinical challenge associated with considerable morbidity, including colectomy. Upadacitinib (UPA), a selective Janus kinase (JAK)-1 inhibitor, is approved for moderate-to-severe ulcerative colitis in patients intolerant or not responding to tumor necrosis factor-alpha inhibitors. It has also increasingly been used off-label for ASUC. We performed a systematic review of all available literature on UPA in ASUC. We identified 11 studies, with a pooled total of 55 patients. Most patients experienced rapid and sustained improvement. Colectomy rate at 90 days was 16.3%. Among those who did not get colectomy, 80% were in steroid-free remission at follow-up. The reported adverse events were low, including 2 venous thromboembolic events. Overall, UPA appears to represent a safe and effective therapy for ASUC.© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.