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. Sep 5, 2026; 17(3): 122912
Published online Sep 5, 2026. doi: 10.4292/wjgpt.122912
Published online Sep 5, 2026. doi: 10.4292/wjgpt.122912
Letter to the Editor: Can upadacitinib dose escalation redefine treatment strategies in refractory inflammatory bowel disease?
Himanshu Agrawal, Department of Surgery, University College of Medical Sciences (University of Delhi), GTB Hospital, Delhi 110095, India
Nikhil Gupta, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
Co-first authors: Himanshu Agrawal and Nikhil Gupta.
Author contributions: Agrawal H conceptualized the manuscript, performed literature review, drafted the manuscript, and critically revised the intellectual content; Gupta N contributed to manuscript design, literature review, scientific interpretation, critical revision of the manuscript, and supervision of the work; Both authors approved the final version of the manuscript and agree to be accountable for all aspects of the work.
AI contribution statement: No AI tools such as ChatGPT, Grammarly, DeepL, or similar platforms were used to generate the scientific content of this manuscript. The authors used ChatGPT (OpenAI) for language refinement, structural reorganization and editing without altering the manuscript’s scientific content, interpretation, or conclusions. All scientific content and interpretation were developed and verified by the authors. No AI tool contributed to the study design, data analysis, or interpretation of results. All intellectual input and scientific decisions were made solely by the authors. No images, figures, or graphical content included in this manuscript were generated using AI.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Nikhil Gupta, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India.
Received: May 8, 2026
Revised: May 18, 2026
Accepted: June 1, 2026
Published online: September 5, 2026
Processing time: 119 Days and 8.7 Hours
Revised: May 18, 2026
Accepted: June 1, 2026
Published online: September 5, 2026
Processing time: 119 Days and 8.7 Hours
Core Tip
Core Tip: Upadacitinib dose escalation may provide symptomatic benefit and reduce corticosteroid dependence in selected patients with refractory inflammatory bowel disease who experience secondary loss of response. The findings of Ellington et al support a more flexible and individualized approach to therapeutic optimization while emphasizing the need for careful safety monitoring and prospective validation.