Age-Stratified Efficacy of Upadacitinib in Refractory Pediatric Crohn’s Disease and Geriatric Ulcerative Colitis: An Asian Cohort Study
Abstract
Background and Aims Inflammatory Bowel Disease presents significant management challenges, particularly in pediatric and elderly populations with refractory conditions. Despite advances in biologic therapies, current treatments remain limited with inconsistent response rates. This study investigated Upadacitinib efficacy in Asian adolescent and elderly populations with refractory IBD. Methods This single-center, retrospective cohort study examined 21 patients at the Sixth Affiliated Hospital of Sun Yat-sen University: 11 pediatric refractory CD patients (aged 9–17) and 10 elderly refractory UC patients (aged 60+). Diagnoses were confirmed via comprehensive criteria including clinical symptoms, biomarkers, endoscopic findings, histological examination, and radiological results. Patients had refractory IBD, defined as failure of at least two biologic agents with distinct mechanisms or comorbid psychosocial complications impairing disease management. Results Pediatric CD patients showed remarkable efficacy, with 72.7% achieving steroid-free clinical remission at week 12, maintained at 57.1% by week 24, and reaching 88.9% at final follow-up. Endoscopic remission improved from 50% at week 12 to 57.1% at final follow-up. Elderly UC patients showed modest outcomes, with 20% achieving clinical remission throughout the study. Laboratory parameters demonstrated significant improvements, particularly in C-reactive protein and albumin levels. The safety profile was generally favorable…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 21 participants or records.
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