急性严重溃疡性结肠炎（ASUC）仍然是一个与相当大的发病率相关的临床挑战，包括结肠切除术。 Upadacitinib (UPA) 是一种选择性 Janus 激酶 (JAK)-1 抑制剂，被批准用于治疗对肿瘤坏死因子-α 抑制剂不耐受或无反应的中重度溃疡性结肠炎患者。它也越来越多地在 ASUC 适应症外使用。我们对 ASUC 中 UPA 的所有可用文献进行了系统回顾。我们确定了 11 项研究，总计 55 名患者。大多数患者经历了快速且持续的改善。 90 天时结肠切除率为 16.3%。在未接受结肠切除术的患者中，80% 在随访时处于无类固醇缓解状态。报告的不良事件很少，包括 2 起静脉血栓栓塞事件。总体而言，UPA 似乎代表了 ASUC 的一种安全有效的疗法。© 作者 2024。由牛津大学出版社代表克罗恩病出版

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.