Rinvoq (upadacitinib) / AbbVie - LARVOL DELTA

Bridging the Treatment Access Gap: Janus Kinase Inhibitors as First-line Advanced Therapy for Inflammatory Bowel Disease in Resource-variable Settings. (PubMed, Euroasian J Hepatogastroenterol) - "With respect to onset kinetics, JAK inhibitors outpace every biologic class; upadacitinib produced symptomatic remission in 68% by week 2, contrasted with 15.7-22% for vedolizumab, ustekinumab, and tumor necrosis factor (TNF) antagonists...This review presents the first regionally anchored framework for deploying JAK inhibitors in clinical contexts where the operative decision is not between a JAK inhibitor and a biologic, but between a JAK inhibitor and the total absence of advanced therapy. For gastroenterologists practicing throughout the Euroasian region under conditions of restricted biologic availability, limited infusion capacity, and absent therapeutic drug monitoring (TDM), this review furnishes an evidence-grounded rationale for deploying JAK inhibitors as first-line advanced therapy, supported by efficacy data, safety evidence, and pragmatic considerations tailored to resource-variable healthcare systems."

Journal • Cardiovascular • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Herpes Zoster • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Oncology • Rheumatoid Arthritis • Rheumatology • Ulcerative Colitis • Varicella Zoster • Venous Thromboembolism

Editorial: Beyond the Matrix-Upadacitinib in Real-World Refractory Crohn's Disease. (PubMed, Aliment Pharmacol Ther) - No abstract available

Journal • Real-world evidence • Crohn's disease • Gastroenterology • Immunology • Inflammatory Bowel Disease

Medical Therapies Beyond Infliximab for Perianal Fistulizing Crohn's Disease: Current Evidence and Future Perspectives. (PubMed, J Clin Med) - "Current evidence suggests that ustekinumab and upadacitinib remain effective following anti-TNF failure, while vedolizumab demonstrates limited efficacy. Evidence supporting IL-23 inhibitors, including risankizumab and guselkumab, is limited but rapidly evolving, with ongoing prospective trials expected to clarify their role. Novel approaches such as advanced dual-targeted therapy, subcutaneous infliximab optimization, hyperbaric oxygen therapy, and exclusive enteral nutrition have also shown encouraging preliminary results in selected patients...Future adequately powered randomized controlled trials using harmonized clinical and magnetic resonance imaging -based outcomes are essential to establish optimal treatment sequencing and improve long-term fistula healing. Until then, individualized multidisciplinary management remains fundamental to optimizing outcomes in patients with pfCD."

Journal • Review • Crohn's disease • Gastroenterology • Immunology • Inflammatory Bowel Disease • IL23A

AbbVie Announces European Commission Approval of RINVOQ (upadacitinib) for the Treatment of Children with Active Polyarticular Juvenile Idiopathic Arthritis (AbbVie Press Release) - "The EC approval of RINVOQ for pJIA is supported by the SELECT-YOUTH study and data from adult patients with rheumatoid arthritis."

EMA approval • Idiopathic Arthritis • Immunology

Upadacitinib for Papuloerythroderma of Ofuji: A 24-Month Outcome. (PubMed, Int J Dermatol) - No abstract available

Journal • Dermatopathology

Upadacitinib for Palmoplantar Pustulosis: An Open-label, Assessor-blinded Feasibility Study Using Historic Control Data (JAKPPPOT). (PubMed, Br J Dermatol) - "This study demonstrates that a definitive trial of JAK inhibition in PPP is feasible and identifies an encouraging exploratory efficacy signal. The findings support progression to a multicentre active-comparator randomised controlled trial."

Journal • Acne Vulgaris • Dermatology • Immunology • Infectious Disease • Inflammation • Pain • Psoriasis • Rare Diseases • Respiratory Diseases

Comparative Effectiveness of Janus Kinase Inhibitors Versus Vedolizumab for Chronic Pouchitis (ACG 2026) - "Adult patients, >= 18 years, with pouchitis who received either a JAK inhibitor (tofacitinib or upadacitinib) or vedolizumab were identified. After 1:1 propensity score matching, 336 patients remained in each cohort. Baseline demographics and disease characteristics were well balanced after matching. The mean age was 44 years in both groups; 45% were female; 83% were White.At 1 year, 156 patients (46.4%) in the JAKi cohort and 173 patients (51.5%) in the vedolizumab cohort experienced relapse (aHR 0.94, 95% CI 0.76–1.17, p=0.56)."

HEOR • Gastrointestinal Disorder • Inflammation

Advanced Therapy Exposure Is Associated With Increased Disease-Related Surgery but Not Cancer Risk in PSC-IBD: A Real-World Analysis (ACG 2026) - "Patients receiving advanced IBD therapies (anti-TNF agents, vedolizumab, ustekinumab, tofacitinib, upadacitinib, risankizumab, mirikizumab, or guselkumab) were compared with PSC-IBD patients without advanced therapy exposure. Among 4,116 eligible PSC-IBD patients, 723 advanced-therapy patients were matched to 723 non-advanced therapy patients. Advanced therapy exposure was associated with a significantly increased risk of IBD-related surgery (12.7% vs 5.3%; RR 2.42, 95% CI 1.68â3.48; p< 0.001) and higher corticosteroid utilization (59.3% vs 47.9%; RR 1.24, 95% CI 1.13â1.37; p< 0.001). Advanced therapy patients also demonstrated shorter surgery-free survival (HR 2.43, 95% CI 1.67â3.55; p< 0.001)."

Clinical • Metastases • Real-world • Real-world evidence • Surgery • Biliary Cancer • Cholangiocarcinoma • Colorectal Cancer • Crohn's disease • Gallbladder Cancer • Gastroenterology • Gastrointestinal Disorder • Hepatocellular Cancer • Hepatology • Immunology • Inflammatory Bowel Disease • Oncology • Primary Sclerosing Cholangitis • Solid Tumor • Ulcerative Colitis

Clinical and Safety Outcomes of Refractory Crohn's Disease Patients on Dual Advanced Therapy With IL-23 and Jak Inhibitor (ACG 2026) - "IL-23 inhibitors (Guselkumab, Mirikizumab, Risankizumab-rzaa) and Jak inhibitors (Upadacitinib) have become the most utilized in refractory Crohnâs patients, but their clinical outcomes remain less than ideal . Eighteen Crohn's patients on DAT were identified. On average, patients failed five different biologics prior to DAT and were on DAT for approximately 8 months. Seventy-two percent of Crohnâs patients on DAT reported clinical improvement."

Clinical • Metastases • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Inflammatory Bowel Disease • IL23A

Safety and Effectiveness of Janus Kinase Inhibitors Versus Infliximab in Older Adults With Inflammatory Bowel Disease (ACG 2026) - " This single-center retrospective cohort study included adults with IBD who were started on either IFX or JAKi (upadacitinib or tofacitinib) at ageâ¥55 years old. A total of 386 patients were included in the study (JAKi n=148, mean age 64 years vs. IFX n=238, median age 62, p=0.004, Table). The JAKi group had higher rates of cardiovascular comorbidities (hypertension, hyperlipidemia, atrial fibrillation, stroke, peripheral vascular disease, pulmonary embolism, angina, or heart failure) at the time of starting medication (75% JAKi vs 58% IFX p=0.001)."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Hypertension • Immunology • Inflammation • Inflammatory Bowel Disease • Peripheral Arterial Disease • Pulmonary Embolism • Respiratory Diseases

Biologic Sequencing After First-Line Anti-TNF Failure in IBD: An Umbrella Review of Meta-Analyses on Second- and Third-Line Options, Comparative Effectiveness, and Treat-to-Target Outcomes (ACG 2026) - "In biologic-experienced UC, upadacitinib ranked highest for maintenance (RR 7.04; 95% CI 2.51-19.79), while tofacitinib and ustekinumab led induction rankings. Fourteen MAs and NMAs met inclusion criteria (10 high-quality, AMSTAR-2 â¥12/16). In anti-TNF-experienced CD, ustekinumab demonstrated superior maintenance remission (OR 1.86; 95% CI 1.23-2.82; I²=80%) and treatment persistence (OR 2.37; 95% CI 1.56-3.62; I²=0%) versus vedolizumab. SUCRA rankings placed ustekinumab (86.19%) and risankizumab (62.56%) highest for induction in TNF-experienced CD."

Clinical • HEOR • Review • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Long-Term Outcomes of Upadacitinib in Patients With Crohn's Disease: A Single-Center Retrospective Study (ACG 2026) - "Among 139 CD patients (mean age 40, range 20-77) treated with UPA, the cohort was predominantly male (57.6%), white (87.1%), and had a mean of 2.8 prior biologics per patient. 71.2% received a maintenance dose of 30 mg daily. At baseline, 27.8% were on corticosteroids at UPA initiation, and 17.7% had been hospitalized in the prior 6 months."

Retrospective data • Crohn's disease • Gastroenterology • Immunology • Inflammatory Bowel Disease

Efficacy and Safety of Upadacitinib in Moderate-to-Severe IBD: A Systematic Review of RCTs in Biologic-Naïve and Biologic-Experienced Populations (ACG 2026) - "Introduction: Upadacitinib (UPA),an oral selective Janus kinase 1 (JAK-1) inhibitor,has emerged as an important therapy for inflammatory bowel disease (IBD).There is a lack of evidence synthesizing its comparative efficacy in biologic-naiÌve versus biologic- experienced (Bio-IR) patients across both Ulcerative Colitis (UC) and Crohnâs Disease (CD).This systematic review evaluates the efficacy, safety, and dose-response relationship of UPA in moderate-to-severe IBD. Five RCTs were included.UPA 45 mg induction therapy showed superior clinical and endoscopic remission rates compared to placebo. In maintenance phases, biologic-naiÌve patients attained the highest remission rates (up to 64.0% in UC and 58.5% in CD at week 52).UPA showed a clinically significant rate of remission of 42% in Bio-IR patients, indicating it may overcome the âceiling effectâ of traditional biologics.The safety analysis demonstrated a dose-dependent increase of adverse..."

Clinical • Review • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Herpes Zoster • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis • Varicella Zoster • IL23A • JAK1

Drug-Induced Pancreatitis Across UC Therapeutics: A Real-World Pharmacovigilance Study (ACG 2026) - " FAERS was queried for reports of pancreatitis associated with UC treatments including immunomodulators (azathioprine, mercaptopurine, methotrexate, tacrolimus), 5-aminosalicylates (mesalamine, balsalazide, olsalazine, sulfasalazine), anti-TNF agents (adalimumab, infliximab, golimumab, certolizumab pegol), integrin inhibitors (vedolizumab, natalizumab), IL-12/23 inhibitors (ustekinumab, risankizumab, guselkumab), JAK inhibitors (tofacitinib, upadacitinib), and S1P modulators (ozanimod, etrasimod). 83,046 reports with 612 pancreatitis cases were analyzed. Significantly elevated risk was observed with azathioprine (ROR 4.38, 95% CI 3.56-5.38), mesalamine (ROR 2.32, 95% CI 1.87-2.89), and infliximab (ROR 1.47, 95% CI 1.21-1.80; all p< 0.0001). Reduced risk was identified with adalimumab (ROR 0.60, 95% CI 0.49-0.74), vedolizumab (ROR 0.69, 95% CI 0.51-0.93), and ustekinumab (ROR 0.13, 95% CI 0.02-0.94)."

Adverse events • Clinical • Real-world • Real-world evidence • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Pancreatitis • Ulcerative Colitis • IL12A • ROR1

Unanticipated Weight Gain After Upadacitinib Initiation in Inflammatory Bowel Disease: A National Veterans Affairs Cohort Study (ACG 2026) - "Among 1,417 patients, IBD-UPA had statistical significance with weight outcomes across all primary endpoints. IBD-UPA patients experienced greater weight gain than those with IBD-other, with an adjusted mean difference of +3.3 lbs (95% CI, 1.1-5.4; p = 0.0007). IBD-UPA was also associated with increased hazard of =5% weight gain (HR 1.90; 95% CI, 1.48-2.42) and =10% weight gain (HR 2.82; 95% CI, 1.89-4.21)."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease

Looking Beyond Clostridioides Difficile: Persistent Diarrhea Unmasking PembrolizumabâInduced ImmuneâMediated Colitis (ACG 2026) - "She continued to have 5â7 loose bowel movements daily and crampy abdominal pain despite oral vancomycin and a switch to fidaxomicin after 5 days...Disease was refractory to corticosteroids and infliximab but ultimately responded to upadacitinib...Figure: Figure 2. Gross bloody diarrheal stool and representative colonoscopic images from the ascending, descending, and sigmoid colon demonstrating diffuse erythema, friability, and ulceration, consistent with severe pancolitis due to immuneâmediated colitis in the setting of pembrolizumab therapy."

Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Lung Cancer • Solid Tumor

When Three Stars Align: A Therapeutic Challenge (ACG 2026) - "Given recurrent active disease and concomitant axial symptoms, infliximab induction therapy was started. (B) Interval improvement after initiation of upadacitinib. (C,D) Additional improvement in truncal and intertriginous psoriatic lesions following therapy transition."

Ankylosing Spondylitis • Axial Spondyloarthritis • Back Pain • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Arthritis • Inflammatory Bowel Disease • Musculoskeletal Pain • Psoriasis • Seronegative Spondyloarthropathies • Spondylarthritis • Ulcerative Colitis • Ulcerative proctitis

From Gastrointestinal Graft-vs-Host Disease to Crohn Disease and Back Again: A Diagnostic Challenge in Post-Transplant Colitis (ACG 2026) - "Symptoms significantly improved with prednisone, vedolizumab, and ruxolitinib...He was treated with budesonide, upadacitinib, vedolizumab, infliximab, AAT, and thymoglobulin to target CD and GI GVHD...Further studies are needed to better characterize the relationship between post-transplant immune dysregulation and de novo IBD. Figure: March 2025 colonoscopy demonstrating Crohnâs Disease with active chronic ileocolitis with granulomas Figure: January 2026 colonoscopy demonstrating GI GVHD with focal ulcer and acute inflammation with increased apoptosis and focal loss of crypt"

Post-transplantation • Crohn's disease • Essential Thrombocythemia • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Graft versus Host Disease • Hematological Disorders • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Myelofibrosis • Thrombocytosis • Transplantation

Majocchi's Granuloma in Crohn's Disease: A Diagnostic Mimic of Cutaneous Extraintestinal Manifestations and a Potential Opportunistic Infection Associated With Janus Kinase Inhibitor Therapy (ACG 2026) - "Janus kinase (JAK) inhibitors, such as upadacitinib, increase susceptibility to fungal opportunistic infections...Figure: Initial presentation of erythematous, indurated plaque with papules and pustules. Figure: Partial improvement of rash after empiric topical therapy."

Crohn's disease • Gastroenterology • Immunology • Infectious Disease • Inflammatory Bowel Disease • Pyoderma Gangrenosum

Cutaneous Kaposi Sarcoma in a Patient With Ulcerative Colitis: Progression on Infliximab and Regression After Withdrawal (ACG 2026) - "If colitis relapses, non-TNF options require caution, as KS has also been reported with vedolizumab, tofacitinib, ozanimod, and upadacitinib. (D) Marked regression ~6 months after infliximab withdrawal, with residual hyperpigmented macules and scarring. (consented)"

Clinical • Dermatopathology • Epstein-Barr Virus Infections • Gastroenterology • Gastrointestinal Disorder • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammatory Bowel Disease • Kaposi Sarcoma • Sarcoma • Solid Tumor • Ulcerative Colitis • CD34 • TNFA

Fistulizing Crohn's Disease With Rectovaginal and Perianal Involvement Following Ocrelizumab Therapy in Multiple Sclerosis (ACG 2026) - "She received a prednisone taper and surgical fistula repair...Upadacitinib is planned for ongoing fistulizing disease...Figure: Figure 1. (C, D) March 2026: complete resolution of inflammation with restoration of normal mucosal vascular pattern and haustral architecture (SES-CD 4)."

CNS Disorders • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Multiple Sclerosis

Sight-Threatening Bilateral Endogenous Fungal Endophthalmitis Following Immunosuppressive Therapy for Crohnâs Colitis (ACG 2026) - "He had recently started upadacitinib and a prolonged corticosteroid taper for severe refractory colitis...Treatment consisted of systemic voriconazole and serial intravitreal amphotericin injections...Elevated serum beta-D-glucan, worsening ocular inflammation despite corticosteroid therapy, and vitreous histopathology demonstrating pseudohyphae and budding yeast were critical in establishing the diagnosis. This case highlights the importance of maintaining a high index of suspicion for opportunistic fungal infection in immunosuppressed patients with IBD presenting with ocular symptoms, even when cultures are negative."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Ocular Infections • Ocular Inflammation • Ophthalmology • Uveitis

Upadacitinib in Anti-TNFâRefractory Crohn's Disease Complicated by Latent TB and Breakthrough Herpes Zoster (ACG 2026) - "Although Infliximab remains a standard rescue therapy, some patients fail to respond and require alternative advanced therapies. Emerging evidence suggests upadacitinib may provide effective salvage therapy after corticosteroid and anti-TNF failure. This case emphasizes the importance of multidisciplinary management and careful infectious risk stratification prior to escalation of immunosuppression."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Herpes Zoster • Immunology • Infectious Disease • Inflammatory Bowel Disease • Peptic Ulcer • Respiratory Diseases • Tuberculosis • Varicella Zoster

Combination Biologic Therapy With Infliximab and Guselkumab for Refractory Ileocolonic Crohn's Disease Managed Primarily via Telehealth: A Case Report (ACG 2026) - "This case illustrates the successful use of infliximab, guselkumab, and methotrexate in refractory ileocolonic CD managed via telehealth. Case Description/ A 56-year-old male with a >20-year history of stricturing, penetrating ileocolonic CD presented with persistent disease despite sequential advanced therapies: adalimumab (failed 2022), infliximab (failed 2023), risankizumab (failed 2025), and upadacitinib (failed 2025 due to worsening disease and severe acne/psoriasis)...(3) Telehealth Utility: High-frequency virtual touchpoints (every 1â2 months) facilitated close symptom tracking and laboratory safety surveillance, consistent with evidence that telehealth improves quality of life without compromising IBD outcomes. DBT should be considered before surgical escalation in refractory CD, and these complex IBD patients can be effectively managed via telehealth."

Case report • Clinical • Acne Vulgaris • Crohn's disease • Gastroenterology • Immunology • Inflammatory Bowel Disease • Psoriasis • IL23A

Pulmonary Nodules as an Extraintestinal Manifestation of Crohnâs Disease Mimicking Infection During Disease Flare (ACG 2026) - "She had failed infliximab, adalimumab and vedolizumab...After IV corticosteroids and upadacitinib, repeat imaging showed near complete resolution...Response to these therapies can help clarify the diagnosis when the workup is inconclusive. Figure: A: CT Chest imaging showing left lower lobar cavitary lesion Figure: B: CT Chest imaging showing smaller peripheral pulmonary opacities"

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Bowel Disease • Pulmonary Disease • Respiratory Diseases • Vasculitis