{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:14:08Z","timestamp":1787850848398,"version":"build-2784847793"},"reference-count":7,"publisher":"Baishideng Publishing Group Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Gastrointest Pharmacol Ther"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Upadacitinib is a selective Janus kinase-1 (JAK1) inhibitor approved for the treatment of moderate-to-severe ulcerative colitis (UC) and Crohn\u2019s disease (CD). Standard therapy consists of induction dosing at 45 mg daily followed by maintenance dosing of 15-30 mg daily. Although pivotal trials demonstrated sustained efficacy with maintenance therapy, secondary loss of response occurs in clinical practice. Data regarding the effectiveness of dose re-escalation remain limited.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To evaluate clinical outcomes following upadacitinib dose escalation in inflammatory bowel disease (IBD) with loss of response to maintenance dosing.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>We conducted a single-center retrospective cohort study of adults with IBD who underwent re-escalation to upadacitinib 45 mg daily beyond the labeled induction period. Data were obtained through electronic medical record review. The primary endpoint was clinical response, defined as provider-documented symptom improvement and\/or objective improvement in biomarkers or endoscopic assessment. Secondary outcomes included indications for escalation, corticosteroid exposure, IBD-related healthcare utilization, and treatment durability.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>A total of 56 patients were included [38 CD, 18 UC; median age 34 years (interquartile range: 26-46), 43% female] with a mean of 2.49 prior biologic exposures. Among 49 patients with paired symptom data, abdominal pain decreased from 57% to 29% (P  = 0.003), hematochezia from 49% to 20% (P  = 0.004), urgency from 45% to 16% (P  = 0.003), and diarrhea from 55% to 37% (P  = 0.049). Corticosteroid use declined from 50% to 32% (P  = 0.031). The proportion with \u2265 1 IBD-related hospitalization or emergency department visit decreased from 32% to 20%. Biomarkers and endoscopic outcomes improved numerically but were limited by small paired samples. At most recent follow-up, 89% of patients remained on escalated dosing.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>In this single-center cohort, upadacitinib dose escalation improves symptoms and reduces corticosteroid use, supporting dose intensification as a pragmatic strategy for secondary loss of response.<\/jats:p>","DOI":"10.4292\/wjgpt.v17.i2.120059","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T01:48:16Z","timestamp":1779846496000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of upadacitinib dose escalation in inflammatory bowel disease: A single-center retrospective cohort study"],"prefix":"10.4292","volume":"17","author":[{"given":"Abigail Layton","family":"Ellington","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Rambuss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Barbina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maithili","family":"Chitnavis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.07.008"},{"key":"B2","unstructured":"RINVOQ\u00ae (upadacitinib) Receives FDA Approval for the Treatment of Adults with Moderately to Severely Active Ulcerative Colitis. [cited 8 April 2026]. Available from: https:\/\/news.abbvie.com\/2022-03-16-RINVOQ-R-upadacitinib-Receives-FDA-Approval-for-the-Treatment-of-Adults-with-Moderately-to-Severely-Active-Ulcerative-Colitis"},{"key":"B3","unstructured":"FDA approves first oral treatment for moderately to severely active Crohn\u2019s disease. [cited 8 April 2026]. Available from: https:\/\/www.fda.gov\/drugs\/news-events-human-drugs\/fda-approves-first-oral-treatment-moderately-severely-active-crohns-disease"},{"key":"B4","unstructured":"AbbVie.   A Study to Evaluate the Safety and Efficacy of Upadacitinib (ABT-494) for Induction and Maintenance Therapy in Participants With Moderately to Severely Active Ulcerative Colitis (UC). [accessed 2026 Apr 8]. In: ClinicalTrials.gov [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https:\/\/clinicaltrials.gov\/study\/NCT02819635 ClinicalTrials.gov Identifier: NCT02819635"},{"key":"B5","unstructured":"AbbVie.   A Study of the Efficacy and Safety of Upadacitinib in Participants With Moderately to Severely Active Crohn\u2019s Disease Who Have Inadequately Responded to or Are Intolerant to Conventional and\/or Biologic Therapies (U-EXCEL). [accessed 2026 Apr 8]. In: ClinicalTrials.gov [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https:\/\/clinicaltrials.gov\/study\/NCT03345849 ClinicalTrials.gov Identifier: NCT03345849"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.05.001"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.07.042"}],"container-title":["World Journal of Gastrointestinal Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/2150-5349\/full\/v17\/i2\/120059.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/2150-5349\/full\/v17\/i2\/120059.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T01:48:40Z","timestamp":1779846520000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/2150-5349\/full\/v17\/i2\/120059.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":7,"journal-issue":{"issue":"2"},"alternative-id":["120059"],"URL":"https:\/\/doi.org\/10.4292\/wjgpt.v17.i2.120059","relation":{},"ISSN":["2150-5349"],"issn-type":[{"value":"2150-5349","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,5]]}}}