{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:14:33Z","timestamp":1790104473618,"version":"4.0.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["5K23DK125760"],"award-info":[{"award-number":["5K23DK125760"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Data on upadacitinib therapy for pediatric acute severe ulcerative colitis (ASC) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as a salvage therapy in pediatric ASC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children and adolescents with ASC who were treated with upadacitinib for the induction of remission were enrolled in this retrospective multicenter study. Demographic, clinical, and laboratory data as well as adverse events (AEs) were recorded after the 8-week induction period and throughout 26\u2009weeks of therapy. Analyses were based on the intention-to-treat principal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-two patients were included (median age 15.7 [interquartile range 13.5-16.6] years, 12 hospitalized), all with anti-tumor necrosis factor (TNF) therapy refractory disease. Ten patients were treated with corticosteroids at baseline, and upadacitinib was added to an ongoing biologic therapy in five patients. At week 8 of therapy, 11 (50%) patients of the cohort remained colectomy-free and in corticosteroid-free clinical remission (CFR), and 17 (77%) patients remained colectomy-free. Normal C-reactive protein (CRP) was achieved in 9 of 11 (82%) patients who were in CFR, and fecal calprotectin &amp;lt;150\u2009mcg\/g in 4 of 6 (67%) patients with available data. By week 26, 14 (64%) were in CFR and 16 (73%) patients remained colectomy-free. All these patients had normal CRP levels, and 4 of 7 patients with available data had fecal calprotectin &amp;lt;150\u2009mcg\/g. Twelve patients reported AEs, including two serious AEs of an appendiceal neuroendocrine tumor and cytomegalovirus colitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Upadacitinib is an effective induction therapy for children and adolescents with ASC after failing anti-TNF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf166","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T14:09:10Z","timestamp":1752502150000},"page":"3320-3326","source":"Crossref","is-referenced-by-count":7,"title":["Real-World Experience with Upadacitinib for Pediatric Acute Severe Ulcerative Colitis: An International Multicenter Retrospective Study from the Pediatric IBD Porto Group of ESPGHAN"],"prefix":"10.1093","volume":"31","author":[{"given":"Anat","family":"Yerushalmy-Feler","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology Unit, \u201cDana-Dwek\u201d Children\u2019s Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A","family":"Spencer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzannah","family":"Bergstein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Pediatrics, Stanford University School of Medicine , Stanford, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1836-3745","authenticated-orcid":false,"given":"Katarina","family":"Mitrova","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital , Prague,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ondrej","family":"Hradsky","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital , Prague,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-8248","authenticated-orcid":false,"given":"Matteo","family":"Bramuzzo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health-IRCCS \u201cBurlo Garofolo\u201d , Trieste,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Wlazlo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children\u2019s Memorial Health Institute , Warsaw,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Olbj\u00f8rn","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Medicine, Akershus University Hospital , L\u00f8renskog,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Rungoe","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescence Medicine, Copenhagen University Hospital\u2014Amager and Hvidovre , Hvidovre,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Weil","sequence":"additional","affiliation":[{"name":"The Faculty of Medicine, Technion, Israel Institute of Technology , Haifa,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Turner","sequence":"additional","affiliation":[{"name":"The Juliet Keidan Institute of Paediatric Gastroenterology and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem , Jerusalem,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6190-3217","authenticated-orcid":false,"given":"Shlomi","family":"Cohen","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, \u201cDana-Dwek\u201d Children\u2019s Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"2025120914514009600_izaf166-B1","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1053\/j.gastro.2007.05.029","article-title":"Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study","volume":"133","author":"Turner","year":"2007","journal-title":"Gastroenterology."},{"key":"2025120914514009600_izaf166-B2","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1097\/MPG.0b013e31829f7d8c","article-title":"Hungarian IBD Registry Group (HUPIR). Incidence, Paris classification, and follow-up in a nationwide incident cohort of pediatric patients with inflammatory bowel disease","volume":"57","author":"Muller","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2025120914514009600_izaf166-B3","doi-asserted-by":"crossref","first-page":"e509","DOI":"10.1016\/j.crohns.2013.03.007","article-title":"Presenting features and disease course of pediatric ulcerative colitis","volume":"7","author":"Aloi","year":"2013","journal-title":"J Crohns Colitis."},{"key":"2025120914514009600_izaf166-B4","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1136\/gutjnl-2014-306999","article-title":"Early endoscopic, laboratory and clinical predictors of poor disease course in paediatric ulcerative colitis","volume":"64","author":"Schechter","year":"2015","journal-title":"Gut."},{"key":"2025120914514009600_izaf166-B5","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/MPG.0000000000002036","article-title":"Management of paediatric ulcerative colitis, part 2: acute severe colitis-an evidence-based consensus guideline from the European Crohn\u2019s and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition","volume":"67","author":"Turner","year":"2018","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"2025120914514009600_izaf166-B6","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1002\/ibd.21383","article-title":"Acute severe ulcerative colitis in children: a systematic review","volume":"17","author":"Turner","year":"2011","journal-title":"Inflamm Bowel Dis."},{"key":"2025120914514009600_izaf166-B7","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1053\/j.gastro.2010.02.047","article-title":"Severe pediatric ulcerative colitis: a prospective multicenter study of outcomes and predictors of response","volume":"138","author":"Turner","year":"2010","journal-title":"Gastroenterology."},{"key":"2025120914514009600_izaf166-B8","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.dld.2015.01.156","article-title":"Managing paediatric acute severe ulcerative colitis according to the 2011 ECCO-ESPGHAN guidelines: efficacy of infliximab as a rescue therapy","volume":"47","author":"Aloi","year":"2015","journal-title":"Dig Liver Dis."},{"key":"2025120914514009600_izaf166-B9","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1016\/S0140-6736(22)00581-5","article-title":"Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials","volume":"399","author":"Danese","year":"2022","journal-title":"Lancet"},{"key":"2025120914514009600_izaf166-B10","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.14309\/ajg.0000000000002674","article-title":"Effectiveness of upadacitinib for patients with acute severe ulcerative colitis: a multicenter experience","volume":"119","author":"Berinstein","year":"2024","journal-title":"Am J Gastroenterol"},{"key":"2025120914514009600_izaf166-B11","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s10238-024-01468-z","article-title":"Effectiveness and safety of upadacitinib in acute severe ulcerative colitis patients from single Chinese IBD Center: a monocentric study","volume":"24","author":"Zhang","year":"2024","journal-title":"Clin Exp Med"},{"key":"2025120914514009600_izaf166-B12","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s10620-024-08302-2","article-title":"Upadacitinib as rescue therapy for the treatment of acute severe colitis in an acute care setting","volume":"69","author":"Clinton","year":"2024","journal-title":"Dig Dis Sci"},{"key":"2025120914514009600_izaf166-B13","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1093\/ibd\/izae038","article-title":"Clinical outcomes at 8-16 weeks after upadacitinib initiation for acute severe ulcerative colitis: a case series in the united states","volume":"30","author":"Dalal","year":"2024","journal-title":"Inflamm Bowel Dis."},{"key":"2025120914514009600_izaf166-B14","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1093\/ecco-jcc\/jjad115","article-title":"Upadacitinib salvage therapy for infliximab-experienced patients with acute severe ulcerative colitis","volume":"17","author":"Gilmore","year":"2023","journal-title":"J Crohns Colitis."},{"key":"2025120914514009600_izaf166-B15","doi-asserted-by":"publisher","first-page":"izae191","DOI":"10.1093\/ibd\/izae191","article-title":"Upadacitinib for acute severe ulcerative colitis: a systematic review","volume":"31","author":"Damianos","year":"2025","journal-title":"Inflamm Bowel Dis."},{"key":"2025120914514009600_izaf166-B16","doi-asserted-by":"publisher","first-page":"jjae182","DOI":"10.1093\/ecco-jcc\/jjae182","article-title":"Upadacitinib for induction of remission in pediatric ulcerative colitis: an international multi-center study","volume":"19","author":"Yerushalmy-Feler","year":"2025","journal-title":"J Crohns Colitis."},{"key":"2025120914514009600_izaf166-B17","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1111\/apt.70016","article-title":"Upadacitinib for induction of remission in paediatric Crohn\u2019s Disease: an international multicentre retrospective study","volume":"61","author":"Cohen","year":"2025","journal-title":"Aliment Pharmacol Ther."},{"key":"2025120914514009600_izaf166-B18","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1002\/jpn3.12408","article-title":"Upadacitinib is associated with clinical response and steroid-free remission for children and adolescents with inflammatory bowel disease","volume":"80","author":"Runde","year":"2025","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"2025120914514009600_izaf166-B19","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1093\/ibd\/izad300","article-title":"Single-center experience with upadacitinib for adolescents with refractory inflammatory bowel disease","volume":"30","author":"Spencer","year":"2024","journal-title":"Inflamm Bowel Dis."},{"key":"2025120914514009600_izaf166-B20","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/jpr3.12124","article-title":"Upadacitinib as salvage therapy in adolescents with acute severe ulcerative colitis refractory to conventional treatments","volume":"5","author":"Dickerson","year":"2024","journal-title":"JPGN Rep"},{"key":"2025120914514009600_izaf166-B21","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/MPG.0000000000000239","article-title":"ESPGHAN revised Porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents","volume":"58","author":"Levine","year":"2014","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"2025120914514009600_izaf166-B22","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1002\/ibd.21493","article-title":"Pediatric modification of the Montreal classification for inflammatory bowel disease: the Paris classification","volume":"17","author":"Levine","year":"2011","journal-title":"Inflamm Bowel Dis."},{"key":"2025120914514009600_izaf166-B23","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1056\/NEJM198712243172603","article-title":"Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study","volume":"317","author":"Schroeder","year":"1987","journal-title":"N Engl J Med."},{"key":"2025120914514009600_izaf166-B24","doi-asserted-by":"crossref","first-page":"S213","DOI":"10.1542\/peds.2009-2107C","article-title":"Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report","volume":"128","author":"Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute","year":"2011","journal-title":"Pediatrics"},{"key":"2025120914514009600_izaf166-B25","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1016\/S0140-6736(12)61084-8","article-title":"Groupe d\u2018Etudes Th\u00e9rapeutiques des Affections Inflammatoires Digestives. Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomised controlled trial","volume":"380","author":"Laharie","year":"2012","journal-title":"Lancet"},{"key":"2025120914514009600_izaf166-B26","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S2468-1253(16)30003-6","article-title":"Infliximab versus ciclosporin for steroid-resistant acute severe ulcerative colitis (CONSTRUCT): a mixed methods, open-label, pragmatic randomised trial","volume":"1","author":"Williams","year":"2016","journal-title":"Lancet Gastroenterol Hepatol."},{"key":"2025120914514009600_izaf166-B27","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1111\/apt.17938","article-title":"Effectiveness and safety of a third-line rescue treatment for acute severe ulcerative colitis refractory to infliximab or ciclosporin (REASUC Study)","volume":"59","author":"Garc\u00eda","year":"2024","journal-title":"Aliment Pharmacol Ther."},{"key":"2025120914514009600_izaf166-B28","doi-asserted-by":"crossref","first-page":"jjaf021","DOI":"10.1093\/ecco-jcc\/jjaf021","article-title":"Janus kinase inhibitors in the management of acute severe ulcerative colitis: a comprehensive review","volume":"19","author":"Gisbert","year":"2025","journal-title":"J Crohns Colitis."},{"key":"2025120914514009600_izaf166-B29","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/ibd\/izad064","article-title":"Dual biologic or small molecule therapy in refractory pediatric inflammatory bowel disease (DOUBLE-PIBD): a multicenter study from the pediatric IBD Porto group of ESPGHAN","volume":"30","author":"Yerushalmy-Feler","year":"2024","journal-title":"Inflamm Bowel Dis."},{"key":"2025120914514009600_izaf166-B30","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1056\/NEJMoa1606910","article-title":"Tofacitinib as induction and maintenance therapy for ulcerative colitis","volume":"376","author":"Sandborn","year":"2017","journal-title":"N Engl J Med."},{"key":"2025120914514009600_izaf166-B31","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.dld.2023.05.021","article-title":"The current role of Tofacitinib in acute severe ulcerative colitis in adult patients: a systematic review","volume":"55","author":"Mpakogiannis","year":"2023","journal-title":"Dig Liver Dis"},{"key":"2025120914514009600_izaf166-B32","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1093\/ecco-jcc\/jjad036","article-title":"Tofacitinib for acute severe ulcerative colitis: a systematic review","volume":"17","author":"Steenholdt","year":"2023","journal-title":"J Crohns Colitis."},{"key":"2025120914514009600_izaf166-B33","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"International organization for the study of IBD. STRIDE-II: an update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD","volume":"160","author":"Turner","year":"2021","journal-title":"Gastroenterology"},{"key":"2025120914514009600_izaf166-B34"}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/31\/12\/3320\/64096553\/izaf166.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/31\/12\/3320\/64096553\/izaf166.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T19:52:01Z","timestamp":1765309921000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article\/31\/12\/3320\/8238802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ibd\/izaf166","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,8,20]]}}}