急性严重溃疡性结肠炎的Upadacitib：系统评价
Upadacitinib for Acute Severe Ulcerative Colitis: A Systematic Review
影响因子:4.30000
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
摘要
急性严重溃疡性结肠炎（ASUC）仍然是与大量发病术相关的临床挑战，包括结肠切除术。 upadacitib（UPA）是一种选择性JANUS激酶（JAK）-1抑制剂，在不耐受或对肿瘤坏死因子-Alpha抑制剂的患者中批准中度至重度溃疡性结肠炎。它也越来越多地用于ASUC。我们对ASUC中UPA的所有可用文献进行了系统的审查。我们确定了11项研究，共有55名患者。大多数患者经历了快速持续的改善。 90天的结肠切除率为16.3％。在没有进行结肠切除术的人中，有80％的人在随访时无类固醇缓解。报告的不良事件较低，包括2个静脉血栓栓塞事件。总体而言，UPA似乎代表了ASUC的安全有效疗法。版权所有。有关商业重复使用，请联系reprints@oup.com，以获取转载和翻译权以进行转载。所有其他权限都可以通过我们的restrimlink服务通过我们网站上文章页面上的“权限链接”获得 - 有关更多信息，请联系journals.permissions.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.