PMID- 37977068
OWN - NLM
STAT- MEDLINE
DCOM- 20231228
LR  - 20240207
IS  - 1878-1705 (Electronic)
IS  - 1567-5769 (Linking)
VI  - 126
DP  - 2024 Jan 5
TI  - Effectiveness and safety of upadacitinib for inflammatory bowel disease: A 
      systematic review and meta-analysis of RCT and real-world observational studies.
PG  - 111229
LID - S1567-5769(23)01556-4 [pii]
LID - 10.1016/j.intimp.2023.111229 [doi]
AB  - BACKGROUND: Upadacitinib, a novel and selective inhibitor of Janus kinase 1, has 
      demonstrated promising efficacy in managing inflammatory bowel disease (IBD). In 
      this systematic review and meta-analysis, our primary aim was to comprehensively 
      assess the therapeutic effectiveness and safety profile of upadacitinib in the 
      treatment of patients with IBD. METHODS: We conducted an extensive literature 
      search across prominent databases, including Medline, Embase, Web of Science, and 
      Cochrane Central, to identify pertinent studies providing insights into the 
      efficacy and safety of upadacitinib in IBD. The primary endpoint was the 
      achievement of clinical remission, while secondary endpoints encompassed clinical 
      response, endoscopic response, endoscopic remission, and the evaluation of 
      adverse events (AEs). RESULTS: In this meta-analysis of nine studies, we 
      categorized results by study type. Clinical remission rates were: RCTs 36 % (95 % 
      CI = 30-42 %), real-world studies 25 % (95 % CI = 1-49 %), retrospective studies 
      40 % (95 % CI = 24-56 %), cohort studies 55 % (95 % CI = 25-85 %). Clinical 
      response rates were: RCTs 61 % (95 % CI = 55-67 %), real-world studies 42 % (95 % 
      CI = 14-70 %), cohort studies 65 % (95 % CI = 57-73 %). Endoscopic remission 
      rates were: RCTs 19 % (95 % CI = 15-24 %), cohort studies 29 % (95 % 
      CI = 5-52 %). Endoscopic response rates were: RCTs 41 % (95 % CI = 36-47 %), 
      cohort studies 57 % (95 % CI = 31-83 %). Incidence rate for any AEs: IBD 69 % 
      (95 % CI = 63-76 %), UC 65 % (95 % CI = 57-74 %), CD 75 % (95 % CI = 67-82 %). 
      CONCLUSION: Cumulative data from real-world studies and trials confirm the 
      efficacy of upadacitinib in IBD induction and maintenance, with consistent 
      safety. However, further long-term studies are needed to understand its sustained 
      effectiveness and safety.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Zheng, Dian-Yu
AU  - Zheng DY
AD  - Department of Gastroenterology, First Hospital of China Medical University, 
      Shenyang City, Liaoning Province, China.
FAU - Wang, Yi-Nuo
AU  - Wang YN
AD  - Department of Gastroenterology, First Hospital of China Medical University, 
      Shenyang City, Liaoning Province, China.
FAU - Huang, Yu-Hong
AU  - Huang YH
AD  - Department of Gastroenterology, First Hospital of China Medical University, 
      Shenyang City, Liaoning Province, China.
FAU - Jiang, Min
AU  - Jiang M
AD  - Department of Gastroenterology, First Hospital of China Medical University, 
      Shenyang City, Liaoning Province, China.
FAU - Dai, Cong
AU  - Dai C
AD  - Department of Gastroenterology, First Hospital of China Medical University, 
      Shenyang City, Liaoning Province, China. Electronic address: 
      congdai2006@sohu.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20231116
PL  - Netherlands
TA  - Int Immunopharmacol
JT  - International immunopharmacology
JID - 100965259
RN  - 4RA0KN46E0 (upadacitinib)
SB  - IM
MH  - Humans
MH  - *Crohn Disease/drug therapy
MH  - Retrospective Studies
MH  - Remission Induction
MH  - *Inflammatory Bowel Diseases/drug therapy
MH  - *Colitis, Ulcerative/drug therapy
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Adverse events
OT  - Crohn's disease
OT  - Inflammatory bowel disease
OT  - Remission
OT  - Ulcerative colitis
OT  - Upadacitinib
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/11/18 11:42
MHDA- 2023/12/28 06:42
CRDT- 2023/11/17 18:19
PHST- 2023/08/19 00:00 [received]
PHST- 2023/10/23 00:00 [revised]
PHST- 2023/11/11 00:00 [accepted]
PHST- 2023/12/28 06:42 [medline]
PHST- 2023/11/18 11:42 [pubmed]
PHST- 2023/11/17 18:19 [entrez]
AID - S1567-5769(23)01556-4 [pii]
AID - 10.1016/j.intimp.2023.111229 [doi]
PST - ppublish
SO  - Int Immunopharmacol. 2024 Jan 5;126:111229. doi: 10.1016/j.intimp.2023.111229. 
      Epub 2023 Nov 16.