Upadacitinib Provides Rapid Response in Crohn's Disease

A study published in Clinical Gastroenterology and Hepatology found that upadacitinib 45 mg once daily (UPA45) provided rapid relief of clinical symptoms within the first week of treatment in patients with Crohn’s disease (CD).

Researchers evaluated the speed of symptomatic improvement with UPA45 induction therapy. The analysis used pooled data from two phase 3, multicenter, double-blind, 12-week induction trials (U-EXCEL and U-EXCEED) and 1 maintenance trial (U-ENDURE). Daily diary data from the first 15 days of treatment with UPA45 or placebo (PBO) were analyzed for changes in very soft/liquid stool frequency (SF) and abdominal pain score (APS), with clinical outcomes assessed at each study visit.

The study included 1021 patients, with 674 receiving UPA45 and 347 receiving PBO. UPA45 demonstrated superior efficacy compared to PBO in reducing SF and APS, providing rapid relief by day 5 or 6, irrespective of prior biologic exposure. Significant mean changes in SF and APS with UPA45 were observed from week 2 onward (−2.0 and −0.5, respectively; P < .001), and these improvements were sustained through week 12 (−3.0 and −1.0, respectively; P < .001) compared to PBO. The median time to first achieve daily SF/APS clinical remission was earlier with UPA45 (13 days) versus PBO (32 days). Additionally, by week 2, patients treated with UPA45 showed significantly higher rates of SF/APS clinical remission (21.1% UPA45 vs. 8.9% PBO) and clinical response (58.8% UPA45 vs. 37.9% PBO; both P ≤ .01).

UPA45 provided rapid relief of clinical symptoms within the first week of treatment in patients with CD, demonstrating significant and sustained improvements in stool frequency and abdominal pain compared to placebo.

Reference
Colombel JF, Hisamatsu T, Atreya R, et al. Upadacitinib reduces crohn's disease symptoms within the first week of induction therapy. Clin Gastroenterol Hepatol. 2024;22(8):1668-1677. doi:10.1016/j.cgh.2024.02.027