P724 Upadacitinib is Effective and Safe in Tofacitinib-Experienced Patients with Ulcerative Colitis: A Prospective Real-World Experience

Abstract Background The development and availability of Janus kinus inhibitors (JAKinibs) for moderately to severely active ulcerative colitis (UC) provides new therapeutic options with both novel mechanisms unique pharmacodynamic benefits. Tofacitinib (tofa) is a non-selective pan-JAKinib that received FDA approval UC in 2018 upadacitinib (upa) JAK-1 selective inhibitor, 2022. It unknown whether patients who do not respond tofa will subsequently upa. We report our real-world experience upa primary or secondary non-response tofa. Methods performed prospective analysis clinical outcomes on Crohn’s disease (CD) using pre-determined intervals at weeks 0, 2, 4, 8 as part formalized treatment protocol institution. used the SCCAI HBI, well CRP fecal calprotectin (FCP) assess efficacy recorded treatment-related adverse events serious (AEs). Here we treated have been previously Results 26 (18=UC, 8=CD) (Table 1) In addition tofa, all these failed least two biologics prior treatment. UC: by week 2 60% (6/10) achieved response, 40% (4/10) remission. By 4 87.5% (7/8) remission, (6/8) steroid-free remission; FCP decreased mean 649.2 μg/g from baseline (+/- 772.7). At 8: 100% (8/8) (7/7) 180 721.8) baseline. One patient had follow-up 12 continued be 2) CD: 3 were one he remained 2). 6 experienced AEs, most common being acne (19.2%). No infections, MACE, VTE occurred. Conclusion this medically-resistant CD biologics, describe rapidly effective, inducing clinical, steroid-free, biochemical remission no AEs.