Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report
Introduction: Acute severe ulcerative colitis (ASUC) represents a medical emergency associated with high mortality and morbidity. While corticosteroids are the primary treatment, cases that are unresponsive often require rescue therapy with either infliximab or cyclosporine to reduce the...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2024-12-01
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| Series: | Case Reports in Gastroenterology |
| Online Access: | https://karger.com/article/doi/10.1159/000542711 |
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| author | David Huynh Myat Myat Khaing Richard Gareth Fernandes Reuben Malloy Lei Lin Robert Gilmore Nicole Walker Emi Khoo Jakob Begun |
| author_facet | David Huynh Myat Myat Khaing Richard Gareth Fernandes Reuben Malloy Lei Lin Robert Gilmore Nicole Walker Emi Khoo Jakob Begun |
| author_sort | David Huynh |
| collection | DOAJ |
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Introduction: Acute severe ulcerative colitis (ASUC) represents a medical emergency associated with high mortality and morbidity. While corticosteroids are the primary treatment, cases that are unresponsive often require rescue therapy with either infliximab or cyclosporine to reduce the rate of colectomy. Janus kinase inhibitors, such as tofacitinib and upadacitinib, are a highly efficacious therapy with rapid induction of clinical response in moderate to severe ulcerative colitis (UC). Limited data are available on its use on ASUC. We present the first case utilizing upadacitinib as sequential medical rescue therapy in ASUC as well as intestinal ultrasound as a useful tool for disease and response monitoring. Case Presentation: A 69-year-old female who presented with corticosteroid-refractory ASUC partially responded to dose-intensified infliximab and finally achieved clinical remission with upadacitinib. This resulted in swift clinical remission and significant improvement in her mucosal inflammation on intestinal ultrasound. Conclusion: This successful intervention not only avoided colectomy but demonstrated sustained clinical and sonographic remission 16 weeks of post-treatment. Upadacitinib, with its rapid action and efficacy, shows promise in ASUC and should be supported by registration trials and real-world studies. Despite successful outcomes in this case, further validation and long-term data are necessary. |
| format | Article |
| id | doaj-art-29d5b1c2b08746698dd6fa1e5c843e91 |
| institution | OA Journals |
| issn | 1662-0631 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj-art-29d5b1c2b08746698dd6fa1e5c843e912025-08-20T02:31:55ZengKarger PublishersCase Reports in Gastroenterology1662-06312024-12-011911610.1159/000542711Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case ReportDavid HuynhMyat Myat KhaingRichard Gareth FernandesReuben MalloyLei LinRobert GilmoreNicole WalkerEmi KhooJakob Begun Introduction: Acute severe ulcerative colitis (ASUC) represents a medical emergency associated with high mortality and morbidity. While corticosteroids are the primary treatment, cases that are unresponsive often require rescue therapy with either infliximab or cyclosporine to reduce the rate of colectomy. Janus kinase inhibitors, such as tofacitinib and upadacitinib, are a highly efficacious therapy with rapid induction of clinical response in moderate to severe ulcerative colitis (UC). Limited data are available on its use on ASUC. We present the first case utilizing upadacitinib as sequential medical rescue therapy in ASUC as well as intestinal ultrasound as a useful tool for disease and response monitoring. Case Presentation: A 69-year-old female who presented with corticosteroid-refractory ASUC partially responded to dose-intensified infliximab and finally achieved clinical remission with upadacitinib. This resulted in swift clinical remission and significant improvement in her mucosal inflammation on intestinal ultrasound. Conclusion: This successful intervention not only avoided colectomy but demonstrated sustained clinical and sonographic remission 16 weeks of post-treatment. Upadacitinib, with its rapid action and efficacy, shows promise in ASUC and should be supported by registration trials and real-world studies. Despite successful outcomes in this case, further validation and long-term data are necessary. https://karger.com/article/doi/10.1159/000542711 |
| spellingShingle | David Huynh Myat Myat Khaing Richard Gareth Fernandes Reuben Malloy Lei Lin Robert Gilmore Nicole Walker Emi Khoo Jakob Begun Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report Case Reports in Gastroenterology |
| title | Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report |
| title_full | Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report |
| title_fullStr | Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report |
| title_full_unstemmed | Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report |
| title_short | Upadacitinib Was Administered as a Sequential Salvage Therapy for Acute Severe Ulcerative Colitis: A Case Report |
| title_sort | upadacitinib was administered as a sequential salvage therapy for acute severe ulcerative colitis a case report |
| url | https://karger.com/article/doi/10.1159/000542711 |
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