The aim of this retrospective observational study is to investigate and compare the real-world effectiveness and safety of upadacitinib when used as first-line exposure versus rescue exposure in patients with acute severe ulcerative colitis (ASUC). The key questions to be addressed are: In patients with ASUC, does upadacitinib administered as first-line induction exposure result in higher rates of colectomy-free survival, clinical remission, and endoscopic healing compared with its use as rescue exposure following failure of conventional or biologic therapies? What are the differences in the incidence, type, and severity of adverse events between these two real-world treatment exposure patterns? The researchers will conduct a retrospective analysis of medical records and electronic health data from patients diagnosed with ASUC who received upadacitinib either as part of routine first-line clinical care or routine rescue clinical care. All treatment decisions were made by treating clinicians per standard of care; the investigator did not assign or modify any therapeutic interventions. Data will be collected during a defined follow-up period to compare the real-world effectiveness and safety profiles of the two treatment exposure strategies.
This is a retrospective observational cohort study. All interventions described are part of routine clinical care for acute severe ulcerative colitis (ASUC). Treatment decisions were made by treating clinicians per standard of care; the investigator did not prospectively assign, modify, or control any therapeutic interventions. Participants did not receive any intervention specifically for the purpose of this study. The study only involves retrospective analysis of existing medical records to compare real-world outcomes between different treatment exposure patterns.
Study Type
OBSERVATIONAL
Enrollment
81
Upadacitinib was administered orally as part of routine clinical care for acute severe ulcerative colitis (ASUC), in accordance with standard clinical guidelines. The induction dose was 45 mg once daily for up to 12 weeks (8 weeks for most patients, extended to 12 weeks for a subset with severe disease), followed by a maintenance dose of 30 mg once daily. All dosing decisions were made by treating clinicians; the investigator did not assign, modify, or control any dosing regimen for research purposes.
Xijing Hospital,Fourth Military Medical University
Xi'an, Shaanxi, China
Clinical-endoscopic remission rate at 12 weeks
Clinical remission is defined as a total Mayo score ≤ 2 with no subscore \> 1 and a rectal bleeding subscore of 0; endoscopic remission is defined as a Mayo endoscopic subscore ≤ 1 without mucosal friability.Clinical-endoscopic remission requires achievement of both clinical and endoscopic remission, assessed at 12weeks after upadacitinib initiation.
Time frame: 12 weeks after upadacitinib initiation
Colectomy-free rate within 90 days
The proportion of ASUC patients who did not undergo colectomy within 90 days after the initiation of upadacitinib treatment
Time frame: 90 days after upadacitinib initiation
Patient-Reported Outcomes-2 (PRO2) score at week 1
Time frame: 1 week after upadacitinib initiation
Clinical response rate at weeks 8 and 12
Time frame: 8 weeks and 12 weeks after upadacitinib initiation
Clinical remission rate at weeks 8 and 12
Time frame: 8 weeks and 12 weeks after upadacitinib initiation
Corticosteroid-free clinical remission rate at weeks 8 and 12
Time frame: 8 weeks and 12 weeks after upadacitinib initiation
Endoscopic response rate at week 12
Time frame: 12 weeks after upadacitinib initiation
Endoscopic remission rate at week 12
Time frame: 12 weeks after upadacitinib initiation
Adverse events (AEs) rate
Time frame: From upadacitinib initiation to study completion
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