{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:00:49Z","timestamp":1784743249681,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute severe active ulcerative colitis (ASUC) often requires rescue therapy when standard medical treatment fails. Data on the use of upadacitinib (UPA) as a rescue option after failure of steroids and infliximab (IFX) and on the long-term outcomes of UPA treatment up to 48\u2009weeks, remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated hospitalized patients with ASUC (Truelove and Witts criteria) who received UPA following the failure of intravenous corticosteroids (IV-CS) and IFX. Outcomes included UPA persistence, clinical remission (CR), partial Mayo score (pMAYO)\u2009\u2264\u20092, clinical response (\u22653-point reduction in pMAYO), and colectomy rates over 48\u2009weeks of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty patients with ASUC from 11 centers (male, 54%) received UPA treatment following IV-CS\/IFX failure. Prior IFX exposure was 86%, and\u2009&amp;gt;\u200950% of the patients had received\u2009\u2265\u20092 biologics. Continuation was 52% overall (week 4, 90%; week 48, 52%). Discontinuation was due to primary nonresponse (42%), secondary loss of response (46%), or other causes (13%). Adverse events related to UPA occurred in 24% of patients and almost all were nonsevere. Stool frequency, rectal bleeding, pMayo score, and C-reactive protein (CRP) improved rapidly by week 1 and were thereafter maintained to week 48. Colectomy occurred in 22% of patients (nearly half of them in week 1). Week 1 CRs were 60%\/30% while the week 48 CR rate was 51%. Higher baseline CRP predicted colectomy; no factor affected UPA persistence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this multicenter cohort of patients with ASUC who failed IV-CS and IFX rescue, third-line UPA was associated with a low colectomy rate and sustained response up to 1 year, with an acceptable safety profile. UPA may provide sufficient disease control to prevent or delay colectomy, or to serve as a bridge to alternative therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>In this retrospective multicenter cohort (11 centers), 50 patients with severe ulcerative colitis refractory to intravenous corticosteroids and infliximab received upadacitinib. Improved symptoms and C-reactive protein (CRP) levels occurred by week 1 and persisted to week 48; colectomy occurred in 22% and adverse events in 24% of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag126","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:01:13Z","timestamp":1784739673000},"source":"Crossref","is-referenced-by-count":0,"title":["Upadacitinib as a rescue therapy for steroid- and infliximab-refractory acute severe ulcerative colitis: short- and long-term effectiveness and safety in a multicenter cohort study"],"prefix":"10.1093","author":[{"given":"Nalan G\u00fcl\u015fen","family":"\u00dcnal","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Ege University , Izmir, 35040, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8661-5791","authenticated-orcid":false,"given":"O\u011fuz Ka\u011fan","family":"Bakkalo\u011flu","sequence":"additional","affiliation":[{"name":"Cerrahpasa Faculty of Medicine, Department of Gastroenterology, Istanbul University-Cerrahpasa , Istanbul, 34098, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylan","family":"Kav","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Hacettepe University , Ankara, 06230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu\u011f\u00e7e","family":"E\u015fkazan","sequence":"additional","affiliation":[{"name":"Cerrahpasa Faculty of Medicine, Department of Gastroenterology, Istanbul University-Cerrahpasa , Istanbul, 34098, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haluk Tar\u0131k","family":"Kani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Marmara University , Istanbul, 34899, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atilla","family":"Akp\u0131nar","sequence":"additional","affiliation":[{"name":"Cerrahpasa Faculty of Medicine, Department of Gastroenterology, Istanbul University-Cerrahpasa , Istanbul, 34098, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u0131r\u0131l","family":"Ak\u0131nc\u0131o\u011flu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Akdeniz University , Antalya, 07070, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gizem","family":"Da\u011fc\u0131","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Istanbul University , Istanbul, 34093, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim","family":"\u015eendur","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of 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Medicine, Department of Gastroenterology, Dokuz Eyl\u00fcl University , Izmir, 35220, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilger","family":"\u00c7avu\u015f","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Istanbul University , Istanbul, 34093, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevin","family":"Oru\u00e7","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Ege University , Izmir, 35040, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye\u015fim \u00d6zen","family":"Alahdab","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Gastroenterology, Marmara University , Istanbul, 34899, 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