{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:29:19Z","timestamp":1793212159286,"version":"4.5.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Evidence from rheumatology supports a within-class treatment switch for JAK-inhibitors (JAKi), but data in ulcerative colitis (UC) remain limited. We aimed to assess the effectiveness and safety of initiating a second JAKi in patients with UC previously treated with another JAKi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective study, including patients with UC starting a second JAKi after prior JAKi exposure. The primary endpoint was Week 12 steroid-free clinical remission (SFCR\u2014rectal bleeding subscore\u2009=\u20090, stool frequency subscore\u2009\u2264\u20091, and no steroids).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 243 patients (median follow-up: 38 [21-57] weeks). At Weeks 12, 26, and 52, SFCR was achieved in 116\/243 (48%), 120\/243 (49%), and 69\/243 (28%), respectively. Secondary loss of response to the first JAKi was associated with higher SFCR at Week 12 compared to primary failure (odds ratio [OR]\u2009=\u20091.92, 95% confidence interval [CI]\u2009=\u20091.11-3.30, P\u2009=\u20090.02). Higher baseline disease activity (OR\u2009=\u20090.68, 95% CI\u2009=\u20090.68-0.55, P\u2009&amp;lt;\u20090.01) and steroid use (OR\u2009=\u20090.23, 95% CI\u2009=\u20090.13-0.42, P\u2009&amp;lt;\u20090.01) had lower odds of Week 12 SFCR. Endoscopic remission occurred in 22\/243 (9%) (&amp;lt;Week 26) and 27\/243 (11%) (26-78 weeks), and endoscopic improvement in 53\/243 (22%) and 45\/243 (19%), respectively. Sixty-seven (28%) patients discontinued the second JAKi, mostly due to primary (36\/67) or secondary failure (22\/67). Sixty-six adverse events (mostly acne and infections) occurred in 56 (23%) patients, without major thromboembolic or cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Treatment with a second JAKi is effective and safe in patients with UC already exposed to JAKi. Primary failure to a first JAKi and steroid use at initiation of the second JAKi might reduce the likelihood of success with the second JAKi.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf188","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:16:25Z","timestamp":1761743785000},"source":"Crossref","is-referenced-by-count":2,"title":["Sequencing JAK-inhibitors in ulcerative colitis: effectiveness and safety of switching within treatment class"],"prefix":"10.1093","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2154-0490","authenticated-orcid":false,"given":"Tommaso","family":"Innocenti","sequence":"first","affiliation":[{"name":"IBD Referral Centre, Gastroenterology Unit, Careggi University Hospital , Florence,","place":["Italy"]},{"name":"Department of Experimental and Clinical Biomedical Sciences, University of Florence , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3158-8014","authenticated-orcid":false,"given":"Jurij","family":"Han\u017eel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, UMC Ljubljana , Ljubljana,","place":["Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1264-4319","authenticated-orcid":false,"given":"Marie","family":"Truyens","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Pediatrics, Ghent University , Ghent,","place":["Belgium"]},{"name":"Department of Gastroenterology, Ghent University Hospital , Ghent,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1463-3840","authenticated-orcid":false,"given":"Milan","family":"Luka\u0161","sequence":"additional","affiliation":[{"name":"Clinical and Research Center for Inflammatory Bowel Diseases, ISCARE Clinical Centre , Prague,","place":["Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Gordon","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Healthcare Trust , Oxford,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneline","family":"Cremer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Erasme University Hospital , Brussels,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4913-7599","authenticated-orcid":false,"given":"Tam\u00e1s","family":"Moln\u00e1r","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology, University of Szeged , Szeged,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-8950","authenticated-orcid":false,"given":"Mette","family":"Julsgaard","sequence":"additional","affiliation":[{"name":"Department of Hepatology & Gastroenterology, Aarhus University Hospital , Aarhus,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Aarhus University , Aarhus,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7823-7011","authenticated-orcid":false,"given":"Sara","family":"Onali","sequence":"additional","affiliation":[{"name":"Department of Medical Science and Public Health, University of Cagliari , Cagliari,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1073-9496","authenticated-orcid":false,"given":"Alessia","family":"Todeschini","sequence":"additional","affiliation":[{"name":"IBD Unit, IRCCS \u201cSacro Cuore\u2014Don Calabria\u201d , Negrar di Valpolicella,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9554-4785","authenticated-orcid":false,"given":"Olga Maria","family":"Nardone","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federico II University of Naples , Naples,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3426-6408","authenticated-orcid":false,"given":"Nurulamin M","family":"Noor","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust , Cambridge,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8077-8175","authenticated-orcid":false,"given":"Flavio","family":"Caprioli","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano , Milan,","place":["Italy"]},{"name":"Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico di Milano , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-7541","authenticated-orcid":false,"given":"Franco","family":"Scaldaferri","sequence":"additional","affiliation":[{"name":"IBD Unit, CEMAD, UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario \u201cA Gemelli\u201d IRCCS , Rome,","place":["Italy"]},{"name":"Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Argyriou","sequence":"additional","affiliation":[{"name":"IBD Unit, Department of Gastroenterology, University Hospital of Larissa , Larissa,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-2894","authenticated-orcid":false,"given":"Edoardo Vincenzo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, Division of Gastroenterology, University of Padua , Padua,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Brinar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb , Zagreb,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4921-8516","authenticated-orcid":false,"given":"Charlotte R H","family":"Hedin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dermatovenereology and Rheumatology, Centre for Digestive Health, Karolinska University Hospital , Stockholm,","place":["Sweden"]},{"name":"Department of Medicine, Karolinska Institutet , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milagros","family":"Vela Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario Nuestra Se\u00f1ora de Candelaria , Santa Cruz de Tenerife,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1572-0118","authenticated-orcid":false,"given":"Alessandro","family":"Armuzzi","sequence":"additional","affiliation":[{"name":"IBD Unit, IRCCS Humanitas Research Hospital , Milan,","place":["Italy"]},{"name":"Department of Biomedical Sciences, Humanitas University , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9338-4140","authenticated-orcid":false,"given":"Andreas","family":"Blesl","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Medical University of Graz , Graz,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Aratari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, IBD Unit, \u201cSan Filippo Neri\u201d Hospital , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Quadarella","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Fondazione Poliambulanza Istituto Ospedaliero , Brescia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3398-0231","authenticated-orcid":false,"given":"Tommaso Lorenzo","family":"Parigi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8653-1790","authenticated-orcid":false,"given":"Lorenzo","family":"Bertani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pontedera Hospital\u2014Tuscany Northwest ASL , Pontedera,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Ferracane","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Policlinico-San Marco , Catania,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Uzzan","sequence":"additional","affiliation":[{"name":"H\u00f4pital Henri-Mondor Gastroenterology Department, , Cr\u00e9teil,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Michalopoulos","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, General Hospital of Athens \u201cG Gennimatas\u201d , Athens,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"De Bernardi","sequence":"additional","affiliation":[{"name":"IBD Unit, Gastroenterology Unit, Rho Hospital, ASST Rhodense , Rho (Milan),","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Katsanos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology, University of Ioannina , Ioannina,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Balestrieri","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Fondazione Policlinico Campus Bio-Medico , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela","family":"Pi\u00f1ero","sequence":"additional","affiliation":[{"name":"Hospital Universitari Germans Trias i Pujol Gastroenterology Department, , Barcelona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3552-3074","authenticated-orcid":false,"given":"Konstantinos","family":"Karmiris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Venizeleio General Hospital , Heraklion,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Gutierrez","family":"Casbas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, ISABIAL, CIBERehd , Alicante,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Nikolic","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, UMC Maribor , Maribor,","place":["Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Felice","sequence":"additional","affiliation":[{"name":"Department of Medicine (DIMED), Medicine 1, University Hospital of Treviso, University of Padova , Padua,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore , Rome,","place":["Italy"]},{"name":"UOS Gastroenterologia, Ospedale Isola Tiberina Gemelli Isola , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ploutarchos","family":"Pastras","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology, University Hospital of Patras , Patras,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giammarco","family":"Mocci","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, \u201cBrotzu\u201d Hospital , Cagliari,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieven","family":"Pouillon","sequence":"additional","affiliation":[{"name":"Gastroenterology-Hepatology, Imeldaziekenhuis Bonheiden , Bonheiden,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5302-5450","authenticated-orcid":false,"given":"Gerassimos J","family":"Mantzaris","sequence":"additional","affiliation":[{"name":"Department of 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Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis E","family":"Koutroubakis","sequence":"additional","affiliation":[{"name":"University General Hospital of Heraklion Gastroenterology Department, , Heraklion,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6517-7005","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"IBD Unit, Gastroenterology Department, Hospital Universitario Marqu\u00e9s de Valdecilla, IDIVAL , Santander,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Triana","family":"Lobaton","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Pediatrics, Ghent University , Ghent,","place":["Belgium"]},{"name":"Department of Gastroenterology, Ghent University Hospital , Ghent,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Dragoni","sequence":"additional","affiliation":[{"name":"IBD Referral Centre, Gastroenterology Unit, Careggi University Hospital , Florence,","place":["Italy"]},{"name":"Department of Experimental and Clinical Biomedical Sciences, University of Florence , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"The JAKi-SEQ","family":"Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"2026021813590130500_jjaf188-B1","doi-asserted-by":"crossref","first-page":"5318","DOI":"10.3390\/jcm10225318","article-title":"Primary failure to an anti-TNF agent in inflammatory bowel disease: switch (to a second anti-TNF agent) or swap (for another mechanism of 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