Upadacitinib Is Associated with the Lowest Risk of Treatment Failure Among Advanced Therapies for Ulcerative Colitis: A Real-World Administrative Claims Study.

What To Know

A large US administrative-claims study compared real-world outcomes for several advanced therapies used to treat ulcerative colitis: infliximab, adalimumab, vedolizumab, ustekinumab, tofacitinib, and upadacitinib.

The primary outcome was time to treatment failure (IBD-related hospitalization, surgery, or a new corticosteroid prescription >90 days after starting therapy); treatment discontinuation and switching were censored.

After statistical adjustment, upadacitinib was associated with the lowest risk of treatment failure versus each other drug evaluated and had the highest proportion of quarters spent in corticosteroid-free disease stability. The study used a large US claims database and applied propensity-score weighting and competing risk methods to address confounding.

Outcomes reflect administrative claims (hospitalization, surgery, new steroid prescriptions) rather than clinical measures such as endoscopic healing or patient-reported symptoms. This is an observational, non-randomized analysis of real-world data. While the authors adjusted for many confounders, residual confounding and treatment-selection bias may remain.

The results show associations, not cause-and-effect, and may be influenced by prescribing patterns, differences in patient populations, or unmeasured disease severity.