Upadacitinib for refractory ulcerative colitis with primary nonresponse to infliximab and vedolizumab:A case report  

作　　者：Xuan Xu Jing-Wen Jiang Bing-Yun Lu Xia-Xi Li 

机构地区：[1]Department of Gastroenterology,Shenzhen Hospital,Southern Medical University,Shenzhen 518100,Guangdong Province,China [2]The First Clinical Medical School,Southern Medical University,Guangzhou 510515,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2024年第9期1685-1690,共6页世界临床病例杂志

基　　金：Supported by Shenzhen Science and Technology Program,No.JCYJ20220530154013031;Guangdong Province Health and Health Appropriate Technology Promotion Project,No.2023385;Guangdong Province Grassroots Science Popularization Action Plan,No.20240205.

摘　　要：BACKGROUND Many patients with ulcerative colitis(UC)do not respond well to,or tolerate conventional and biological therapies.There is currently no consensus on the treatment of refractory UC.Studies have demonstrated that the selective Janus kinase 1 inhibitor upadacitinib,a small-molecule drug,is effective and safe for treating UC.However,no studies have revealed that upadacitinib is effective in treating refractory UC with primary nonresponse to infliximab and vedolizumab.CASE SUMMARY We report the case of a 44-year-old male patient with a chief complaint of bloody diarrhoea with mucus and pus,in addition to dizziness.The patient had recurrent disease after receiving mesalazine,prednisone,azathioprine,infliximab and vedolizumab over four years.Based on the endoscopic findings and pathological biopsy,the patient was diagnosed with refractory UC.In particular,the patient showed primary nonresponse to infliximab and vedolizumab.Based on the patient’s history and recurrent disease,we decided to administer upadacitinib.During hospitalisation,the patient was received upadacitinib under our guidance.Eight weeks after the initiation of upadacitinib treatment,the patient’s symptoms and endoscopic findings improved significantly.No notable adverse reactions have been reported to date.CONCLUSION Our case report suggests that upadacitinib may represent a valuable strategy for treating refractory UC with primary nonresponse.

关 键 词：Upadacitinib Refractory ulcerative colitis Primary nonresponse INFLIXIMAB Vedolizumab Case report 

分 类 号：R574.62[医药卫生—消化系统]