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Upadacitinib: data from U-ACHIEVE and CELEST

ECCO 2019
Upadacitinib is an oral, selective Janus kinase 1 inhibitor. In a dose-ranging phase 2b/3 induction study, upadacitinib consistently demonstrated significant improvement in endoscopic and histological outcomes as well as mucosal healing compared with placebo in patients with moderately to severely active ulcerative colitis [1]. In moderate-to-severe Crohn’s disease, upadacitinib numerically reduced extra-intestinal manifestations [2]. Patients (n=250) with an adapted Mayo score of 5 to 9 points and centrally read endoscopy subscore of 2 to 3 were randomised to receive placebo or extended-release upadacitinib 7.5 mg, 15 mg, 30 mg, 45 mg once daily for 8 weeks. At baseline, 77.6% had used biologics before, 36% had an adapted Mayo score of >7, and 79% had an endoscopic subscore of 3. At week 8, a dose-response relationship was observed for all efficacy endpoints. The proportion of patients achieving endoscopic improvement, endoscopic remission, histologica...

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