What question did this study set out to answer?

This research aims to evaluate the impact of upadacitinib on extraintestinal manifestations in patients with inflammatory bowel disease in Colombia.

January 23, 2026

P0999Upadacitinib in Extraintestinal Manifestations of Inflammatory Bowel Disease: A Multicentre Colombian Real-World Study

Key Points

This research aims to evaluate the impact of upadacitinib on extraintestinal manifestations in patients with inflammatory bowel disease in Colombia.
Retrospective multicentre study conducted in tertiary IBD units across Colombia.
Included adults with ulcerative colitis or Crohn's disease and active extraintestinal manifestations treated with upadacitinib.
Assessed outcomes such as EIM improvement, clinical remission, and biochemical remission at week 8 and week 24.
At week 8, 71.9% of patients showed improvement in extraintestinal manifestations.
At week 24, 56.3% achieved resolution of EIMs, with 62.5% attaining clinical remission.
Over 52% of patients were able to discontinue steroid use, with mild adverse events reported.

Abstract

Abstract Background Evidence on the efficacy of upadacitinib (UPA) for extraintestinal manifestations (EIMs) in inflammatory bowel disease (IBD) is limited but clinically relevant. Phase 3 trials in Crohn’s disease (CD) and ulcerative colitis (UC) demonstrated efficacy for inducing and maintaining remission in moderate-to-severe IBD; however, pivotal studies (U-EXCEL, U-EXCEED, U-ENDURE) did not show a significant resolution of EIMs during induction. Real-world data suggest that UPA may benefit up to 80% of patients with IBD and concomitant immune-mediated conditions, but no data are available from Latin America, highlighting the need for regional evidence. Methods We conducted a retrospective multicentre study in tertiary IBD units across Colombia. Adults with UC or CD and ≥1 active EIM treated with UPA (15–30 mg) between 2023 and 2025 were included. Clinical, biochemical, and EIM outcomes were assessed at week 8 (induction) and week 24 (maintenance). Primary endpoint: improvement or resolution of EIMs. Secondary endpoints: clinical remission (Mayo 2 or HBI 5), biochemical remission (CRP 5 mg/L; faecal calprotectin 150 µg/g), and corticosteroid withdrawal. Analyses were performed using paired tests and logistic regression with 95% confidence intervals (CI) and p 0.05. Results Thirty-two patients were analysed (21 UC, 11 CD; mean age 39.4 ± 17.2 years; 72% female; median disease duration 8.6 years IQR 5.7–12.4). The most frequent EIMs were articular (59%), cutaneous (18%), and ocular (6%). At week 8, EIM improvement was observed in 71.9% of patients (95% CI: 52.4–85.7), and clinical response in 68.7% (95% CI: 49.6–83.3; p = 0.014). At week 24, EIM resolution was achieved in 56.3% (95% CI: 37.7–73.6), with clinical remission in 62.5% (95% CI: 43.7–78.9; p = 0.018) and biochemical remission in 60.0% (95% CI: 40.7–76.6; p = 0.021). Complete steroid withdrawal occurred in 52.0% of patients (95% CI: 33.3–70.1; p = 0.037). Among those with EIM resolution, 77% achieved parallel biochemical remission and 68% showed endoscopic improvement. No colectomies or treatment discontinuations due to toxicity were reported. Adverse events were mild, mainly acne and transient transaminase elevations (9.5%). No serious infections or thromboembolic events occurred. Conclusion In this real-world Colombian cohort, upadacitinib achieved rapid and sustained improvement of extraintestinal manifestations in IBD, with over 70% of patients responding and more than 50% achieving complete resolution at six months. Improvements correlated with clinical and biochemical remission, and the treatment demonstrated a favourable safety profile. References: 1. Panaccione R, Regueiro M, Lee SD, Atreya R, Pedersen G, Broide E, Rodriguez C, van Bodegraven AA, Dubcenco E, Lacerda AP, Feng T, Geng Z, Wang T, van Haaren S, Anyanwu SI, Panés J. Upadacitinib Maintenance Therapy in Crohn’s Disease: Final Results From the Randomized Phase 3 U-ENDURE Study. Clin Gastroenterol Hepatol. 2025 Jul 28:S1542-3565(25)00643-3. doi: 10.1016/j.cgh.2025.07.028. Epub ahead of print. PMID: 40738276. 2. Colombel JF, Lacerda AP, Irving PM, Panaccione R, Reinisch W, Rieder F, Steinlauf A, Schwartz D, Feng T, Dubcenco E, Anyanwu SI, Laroux FS, Cunneen C, Powell N. Efficacy and Safety of Upadacitinib for Perianal Fistulizing Crohn’s Disease: A Post Hoc Analysis of 3 Phase 3 Trials. Clin Gastroenterol Hepatol. 2025 May;23(6):1019-1029. doi: 10.1016/j.cgh.2024.08.032. Epub 2024 Sep 24. Erratum in: Clin Gastroenterol Hepatol. 2025 Oct;23(11):2054. doi: 10.1016/j.cgh.2025.07.005. PMID: 39326583. Conflict of interest: Parra Izquierdo, Leidy Viviana: No conflict of interest Juliao Baños, Fabián: No conflict of interest Galiano, Maria Teresa: No conflict of interest Riveros, Javier: No conflict of interest Gomez Venegas, Alvaro: No conflict of interest Medrano-Almanza, Carlos: No conflict of interest Ballesteros, Manuel: No conflict of interest Jonathan, Barreto Perez: No conflict of interest Cuadros, Carlos: No conflict of interest Gil Parada, Fabio Leonel: No conflict of interest Guzman, Gerardo: No conflict of interest Florez, Cristian: No conflict of interest Dr. Frías-Ordoñez, Juan: No conflict of interest

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P0999Upadacitinib in Extraintestinal Manifestations of Inflammatory Bowel Disease: A Multicentre Colombian Real-World Study

Key Points

Abstract

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