Which Treatment Leads to Better UC Clinical Responses: Upadacitinib or Ustekinumab?

During the ACG Annual Scientific Meeting, which took place this year from October 20 through 25, one presenter shared insights into a multicenter retrospective cohort study which explored the efficacy of two therapies — upadacitinib and ustekinumab — for people living with ulcerative colitis (UC). Upadacitinib, marketed under the brand name RINVOQ, is a once-daily JAK inhibitor; ustekinumab, marketed under the brand name STELARA, is an immunosuppressive drug used to treat a variety of inflammatory conditions.

Reporting by Healio shared that the results of the study showed that people with UC using upadacitinib were more likely to have a clinical response and reach clinical remission without steroids by 8-16 weeks following treatment when compared to ustekinumab. The researchers determined this using data collected from 70 people treated with upadacitinib and 148 treated with ustekinumab over a 2-year period. People using upadacitinib had higher rates of medication failure prior to their treatment.

Results from the trial show that upadacitinib increased the potential for higher clinical response, as well as both endoscopic and clinical remission. While endoscopic treatment response was close between the two groups, upadacitinib did show slightly more efficacy. The rate of discontinuation due to treatment non-response was similar between the two groups. While the drugs were relatively safe and well-tolerated, there were adverse reactions in both groups. For upadacitinib, the side effects were chest pain and elevated liver enzymes. In the other group, bowel microperforations led to participants stopping treatment.

While these results suggest that upadacitinib might be the better treatment choice for UC, the study authors note that additional research is needed.

Understanding Ulcerative Colitis (UC)

So what is ulcerative colitis? Ulcerative colitis is a chronic inflammatory disease that typically begins in the colon and rectum before spreading throughout the large intestine. It causes the formation of ulcers and sores. Doctors haven’t identified an exact cause for UC, but it’s believed to result from a mix of overactive immune response, genetics, and environmental factors. People who are younger than 30 or older than 60, have a family history of inflammatory bowel diseases (IBD), or have Jewish heritage are more likely to develop ulcerative colitis. Symptoms of ulcerative colitis may include:

  • Abdominal pain and discomfort
  • Bloody stool
  • Loose bowel movements
  • Unintentional weight loss
  • A sense of pressure in the bowel
  • Nausea and vomiting
  • Fatigue
  • Fecal urgency
  • Fever
  • Anemia (low red blood cell counts)
  • Joint pain
  • Rash

Treatment options vary and may include antibiotics, corticosteroids, immunomodulators, biologic medications, aminosalicylates, or surgery. If you have UC, please speak with your doctor to identify the best care plan.

Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

Follow us