Refractory ulcerative colitis: Upadacitinib versus other biologics

doi:10.12998/wjcc.v12.i31.6425

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Nov 6, 2024 (publication date) through Mar 3, 2026

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Nov 6, 2024; 12(31): 6425-6427
Published online Nov 6, 2024. doi: 10.12998/wjcc.v12.i31.6425

Refractory ulcerative colitis: Upadacitinib versus other biologics

Jessy G Fadel, Said G Farhat

Said G Farhat, Jessy G Fadel, Department of Gastroenterology Research, Saint George University of Beirut, Beirut 00000, Lebanon

Said G Farhat, Dr. Sulaiman Al Habib Hospital, Dubai 00000, United Arab Emirates

Author contributions: Farhat SG and Fadel JG contributed to this paper; Farhat SG designed the overall concept; Fadel JG contributed to the writing, discussion, and editing of the manuscript, and literature review; all authors have read and approved the final manuscript.

Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.

Corresponding author: Said G Farhat, MD, Associate Professor, Department of Gastroenterology Research, Saint George University of Beirut, Rmeil Street, Ashrafieh, Beirut 00000, Lebanon. saidfarhat@hotmail.com

Received: March 10, 2024
Revised: July 11, 2024
Accepted: August 1, 2024
Published online: November 6, 2024
Processing time: 184 Days and 8.9 Hours

Abstract

In this editorial we comment on an article published in World Journal of Clinical Cases in 2024, in which a case of refractory ulcerative colitis (UC) was discussed based on the response to different lines of biologics. Different studies showed that different classes of biologics have their advantages and disadvantages in the treatment of refractory UC. Certain classes are superior to others and if tried earlier on would lead to a possible change in the outcome.

Keywords: Refractory; Ulcerative colitis; Upadacitinib; Ustekinumab; Vedolizumab

Core Tip: Ulcerative colitis (UC), a major type of inflammatory bowel disease whose treatment is sometimes challenging and some patients do not respond well to the available therapies. We discuss the case of a patient diagnosed with refractory UC, with primary non-response to infliximab and vedolizumab (VDZ). The patient experienced recurrent symptoms after receiving mesalazine, prednisone, azathioprine, infliximab, and VDZ for more than four years. Through maximizing the upadacitinib (UPA) treatment, UC remission was achieved. This report suggests that the small-molecule UPA may be a new treatment option that requires further research.