Upadacitinib vs Tofacitinib for Clinical Remission in Ulcerative Colitis

Adults with ulcerative colitis had 3 times the odds of achieving steroid-free clinical remission after 52 weeks of upadacitinib compared with tofacitinib, according to a study published in The American Journal of Gastroenterology.

The multicenter, comparative effectiveness investigation included 155 patients with ulcerative colitis. Of the total, 81 patients initiated upadacitinib and about one-third had prior exposure to tofacitinib. Of the 74 patients who initiated tofacitinib, none had prior exposure to upadacitinib.

Researchers sought to determine rates of steroid-free clinical remission and endoscopic response and remission at 52 weeks. 

Patients treated with upadacitinib had 2.3 times higher odds of steroid-free clinical remission at 12 weeks compared with those treated with tofacitinib, according to the study. By 52 weeks, the odds of steroid-free clinical remission were 3.01 times higher with upadacitinib compared with tofacitinib.

“After inverse probability of treatment-weighted logistic regression, upadacitinib was associated with significantly higher odds of steroid-free clinical remission (odds ratio 3.01, 95% confidence interval 1.39–6.55) vs tofacitinib,” wrote corresponding author Rahul S. Dalal, MD, MPH, of Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, and study coauthors.

Rates of endoscopic response and remission did not differ between treatments.

Reference

Dalal RS, Kallumkal G, Cabral HJ, Barnes EL, Allegretti JR. One-year comparative effectiveness of upadacitinib vs tofacitinib for ulcerative colitis: a multicenter cohort study. Am J Gastroenterol. 2024;119(8):1628-1631. doi:10.14309/ajg.0000000000002746