Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan
Ming-Jung Meng,1 Chia-Jung Kuo,1– 5 Ming-Wei Lai,2– 6 Cheng-Tang Chiu,1– 5 Ming-Yao Su,2– 5,7 Ming-Ling Chang,1– 3,5 Puo-Hsien Le1– 5 1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 2Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan; 3Chang...
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Dove Medical Press
2025-02-01
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| author | Meng MJ Kuo CJ Lai MW Chiu CT Su MY Chang ML Le PH |
| author_facet | Meng MJ Kuo CJ Lai MW Chiu CT Su MY Chang ML Le PH |
| author_sort | Meng MJ |
| collection | DOAJ |
| description | Ming-Jung Meng,1 Chia-Jung Kuo,1– 5 Ming-Wei Lai,2– 6 Cheng-Tang Chiu,1– 5 Ming-Yao Su,2– 5,7 Ming-Ling Chang,1– 3,5 Puo-Hsien Le1– 5 1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 2Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan; 3Chang Gung Microbiota Therapy Center, Taoyuan, Taiwan; 4Taiwan Association for the Study of Intestinal Diseases (TASID), Taoyuan, Taiwan; 5School of Medicine, Chang Gung University, Taoyuan, Taiwan; 6Department of Paediatric Gastroenterology, Chang Gung Children’s Hospital, Taoyuan, Taiwan; 7Division of Gastroenterology and Hepatology, Department of Internal Medicine New Taipei Municipal Tucheng Hospital, New Taipei City, TaiwanCorrespondence: Puo-Hsien Le, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital Linkou Branch, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan, 33305, Taiwan, Tel +886-3-3281200 ext 8101, Fax +886-3-3272236, Email puohsien@gmail.comBackground: Refractory inflammatory bowel disease (IBD) remains challenging despite the availability of various biologics. Advanced combination therapy (ACT) with biologics and Upadacitinib (UPA), a rapid-onset oral selective Janus kinase inhibitor, has shown promise in managing refractory IBD. However, its use in Asia has not been explored. This study aims to fill that gap by providing data from Taiwan.Materials and Methods: This retrospective study included refractory IBD patients who received ACT with biologics and UPA, followed up at the Chang Gung Inflammatory Bowel Disease Center from July 2020 to August 2024. Patients were assessed for clinical response and remission at weeks 4, 12, and 24. Safety profiles were monitored throughout the follow-up period to evaluate the risk of adverse events.Results: Sixteen refractory IBD patients were enrolled. The median disease duration was 4.5 years [IQR 2.25– 9.50]. The most common regimen was Ustekinumab plus UPA (63%). Clinical response rates at weeks 4, 12, and 24 were 88%, 83%, and 100%, respectively, while remission rates were 31%, 50%, and 80%. One patient (6.25%) experienced a minor adverse event (acne), with no major events like herpes zoster reactivation or major cardiac complications.Conclusion: This is the first study in Asia to demonstrate that UPA-based ACT is both effective and safe in treating refractory IBD. However, the limitations of this retrospective, single-center study with a relatively small sample size highlight the need for future larger-scale, multi-center prospective studies to confirm these findings, identify predictors of treatment response, and evaluate long-term outcomes.Keywords: inflammatory bowel disease, advanced combination therapy, dual advanced therapy, biologics, upadacitinib |
| format | Article |
| id | doaj-art-e97d0f9dabf44e3c9e1f8f269735a6f6 |
| institution | OA Journals |
| issn | 1178-7031 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Dove Medical Press |
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| series | Journal of Inflammation Research |
| spelling | doaj-art-e97d0f9dabf44e3c9e1f8f269735a6f62025-08-20T02:01:24ZengDove Medical PressJournal of Inflammation Research1178-70312025-02-01Volume 1827332742100567Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from TaiwanMeng MJKuo CJLai MWChiu CTSu MYChang MLLe PHMing-Jung Meng,1 Chia-Jung Kuo,1– 5 Ming-Wei Lai,2– 6 Cheng-Tang Chiu,1– 5 Ming-Yao Su,2– 5,7 Ming-Ling Chang,1– 3,5 Puo-Hsien Le1– 5 1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 2Chang Gung Inflammatory Bowel Disease Center, Taoyuan, Taiwan; 3Chang Gung Microbiota Therapy Center, Taoyuan, Taiwan; 4Taiwan Association for the Study of Intestinal Diseases (TASID), Taoyuan, Taiwan; 5School of Medicine, Chang Gung University, Taoyuan, Taiwan; 6Department of Paediatric Gastroenterology, Chang Gung Children’s Hospital, Taoyuan, Taiwan; 7Division of Gastroenterology and Hepatology, Department of Internal Medicine New Taipei Municipal Tucheng Hospital, New Taipei City, TaiwanCorrespondence: Puo-Hsien Le, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital Linkou Branch, 5, Fu-Hsin Street, Guei-Shan District, Taoyuan, 33305, Taiwan, Tel +886-3-3281200 ext 8101, Fax +886-3-3272236, Email puohsien@gmail.comBackground: Refractory inflammatory bowel disease (IBD) remains challenging despite the availability of various biologics. Advanced combination therapy (ACT) with biologics and Upadacitinib (UPA), a rapid-onset oral selective Janus kinase inhibitor, has shown promise in managing refractory IBD. However, its use in Asia has not been explored. This study aims to fill that gap by providing data from Taiwan.Materials and Methods: This retrospective study included refractory IBD patients who received ACT with biologics and UPA, followed up at the Chang Gung Inflammatory Bowel Disease Center from July 2020 to August 2024. Patients were assessed for clinical response and remission at weeks 4, 12, and 24. Safety profiles were monitored throughout the follow-up period to evaluate the risk of adverse events.Results: Sixteen refractory IBD patients were enrolled. The median disease duration was 4.5 years [IQR 2.25– 9.50]. The most common regimen was Ustekinumab plus UPA (63%). Clinical response rates at weeks 4, 12, and 24 were 88%, 83%, and 100%, respectively, while remission rates were 31%, 50%, and 80%. One patient (6.25%) experienced a minor adverse event (acne), with no major events like herpes zoster reactivation or major cardiac complications.Conclusion: This is the first study in Asia to demonstrate that UPA-based ACT is both effective and safe in treating refractory IBD. However, the limitations of this retrospective, single-center study with a relatively small sample size highlight the need for future larger-scale, multi-center prospective studies to confirm these findings, identify predictors of treatment response, and evaluate long-term outcomes.Keywords: inflammatory bowel disease, advanced combination therapy, dual advanced therapy, biologics, upadacitinibhttps://www.dovepress.com/advanced-combination-therapy-with-biologics-and-upadacitinib-in-refrac-peer-reviewed-fulltext-article-JIRinflammatory bowel diseaseadvanced combination therapydual advanced therapybiologicsupadacitinib |
| spellingShingle | Meng MJ Kuo CJ Lai MW Chiu CT Su MY Chang ML Le PH Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan Journal of Inflammation Research inflammatory bowel disease advanced combination therapy dual advanced therapy biologics upadacitinib |
| title | Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan |
| title_full | Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan |
| title_fullStr | Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan |
| title_full_unstemmed | Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan |
| title_short | Advanced Combination Therapy with Biologics and Upadacitinib in Refractory Inflammatory Bowel Disease: A Retrospective Study from Taiwan |
| title_sort | advanced combination therapy with biologics and upadacitinib in refractory inflammatory bowel disease a retrospective study from taiwan |
| topic | inflammatory bowel disease advanced combination therapy dual advanced therapy biologics upadacitinib |
| url | https://www.dovepress.com/advanced-combination-therapy-with-biologics-and-upadacitinib-in-refrac-peer-reviewed-fulltext-article-JIR |
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