Immunotherapy. 2023 Apr 27. doi: 10.2217/imt-2022-0299. Online ahead of print.

Ariel A Jordan ¹, Peter Dr Higgins ^1 2

Author information

¹Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.

²Division of Gastroenterology & Hepatology, University of Michigan, Ann Arbor, MI 48109, USA.

Abstract

The JAK signaling pathway plays a major role in the immunopathology of autoimmune diseases, including inflammatory bowel disease. JAK enzymes provide novel targets for rapidly effective inflammatory bowel disease therapy, particularly in ulcerative colitis. Upadacitinib is a targeted JAK1 inhibitor. In multiple phase III clinical trials, upadacitinib has demonstrated significant improvement in clinical and endoscopic outcomes and quality of life for patients with moderate-to-severe ulcerative colitis. In this drug evaluation we describe the role of the JAK signaling pathway in ulcerative colitis, the mechanism of action of upadacitinib and the current clinical evidence for its use in ulcerative colitis; we also review its safety and tolerability, including for special populations.