Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Pharmacol Ther. Jun 5, 2026; 17(2): 120059
Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.120059
Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.120059
Clinical outcomes of upadacitinib dose escalation in inflammatory bowel disease: A single-center retrospective cohort study
Abigail Layton Ellington, Danielle Rambuss, Internal Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC 27157, United States
Sarah Barbina, Department of Gastroenterology, Atrium Health Wake Forest Baptist, Winston-Salem, NC 27157, United States
Maithili Chitnavis, Department of Gastroenterology, Atrium Health Carolinas Medical Center, Charlotte, NC 28203, United States
Author contributions: Ellington AL, Chitnavis M, and Barbina S designed the research study; Ellington AL and Rambuss D collected the data; Ellington AL analyzed and interpreted the data; Ellington AL drafted the manuscript; Rambuss D and Barbina S contributed to data interpretation and critical revision of the manuscript for important intellectual content; Chitnavis M contributed to study supervision and critical revision of the manuscript for important intellectual content; all authors reviewed and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Atrium Health Wake Forest Baptist Institutional Review Board (No. 00125815).
Informed consent statement: No signed informed consent forms were obtained, as the requirement for informed consent was formally waived by the Institutional Review Board in accordance with institutional policies and applicable ethical standards.
Conflict-of-interest statement: Chitnavis MV has received consulting and speaker fees from AbbVie and speaking fees from Janssen and Eli Lilly. The other authors declare no financial disclosures or conflicts of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The datasets generated and/or analyzed during the current study are not publicly available due to patient privacy considerations but are available from the corresponding author on reasonable request.
Corresponding author: Abigail Layton Ellington, MD, Internal Medicine, Atrium Health Wake Forest Baptist, 1 Medical Center Blvd, Winston-Salem, NC 27157, United States.
Received: February 14, 2026
Revised: March 10, 2026
Accepted: April 15, 2026
Published online: June 5, 2026
Processing time: 103 Days and 4.5 Hours
Revised: March 10, 2026
Accepted: April 15, 2026
Published online: June 5, 2026
Processing time: 103 Days and 4.5 Hours
Core Tip
Core Tip: Real-world data guiding dose re-escalation of upadacitinib in inflammatory bowel disease (IBD) are limited. In this single-center cohort, off-label intensification in patients with secondary loss of response was associated with significant symptomatic improvement and reduced corticosteroid exposure, with favorable trends in objective measures. Most patients remained on the escalated dose at follow-up. No new laboratory safety signals were observed. These findings suggest dose intensification may represent a pragmatic management strategy in selected patients with IBD.