Upadacitinib Outcomes After Tofacitinib Failure in Patients With Moderate to Severe Ulcerative Colitis.

Evidence for upadacitinib in ulcerative colitis (UC) after tofacitinib failure is limited, with unclear long-term outcomes. A single-centre retrospective case series at a Canadian tertiary hospital included adult UC patients who lost response to tofacitinib and were subsequently treated with upadacitinib (January 2016 to March 2024). Nine patients, who failed a median of four therapies, received upadacitinib. Eight completed induction, and four archived steroid-free clinical remission during maintenance, supported by endoscopic and histologic improvement. Durable remission beyond one year was observed in these four patients, suggesting that upadacitinib may be effective in a subset of patients after tofacitinib failure.