P0817Real-world comparison of time to remission for upadacitinib vs other advanced therapies in patients with moderate-to-severe ulcerative colitis

Background Upadacitinib (UPA), a Janus kinase inhibitor, was approved for adults with moderate-to-severe ulcerative colitis (UC) in 2022. However, real-world data comparing its effectiveness to other advanced therapies (ATs) is limited. This study compared the time to achieve remission for UPA vs other ATs in patients with moderate-to-severe UC. Methods Data were drawn from the Adelphi Real World UC Disease Specific Programme™, a cross-sectional survey with retrospective data collection, of gastroenterologists (GIs) in France, Germany, Italy, Spain, UK and US from February 2023 – October 2024. Patients with a known treatment duration, clinical remission status (GI reported; defined as an absence or reduction in symptoms) and clinical remission achievement date were included in the analysis. GIs reported data on their patients with moderate to severe UC including demographics, treatment utilisation, and remission status. Data were collected in real-life practice, based on the most recent scheduled GI consultation. Time to remission (defined as time from AT initiation to real-world clinical remission) for UPA vs other ATs, including anti–tumour necrosis factor inhibitors (TNFis), vedolizumab, ustekinumab and tofacitinib, was analysed using unadjusted Kaplan-Meier curves and significance was assessed using log-rank tests. Cox-proportional hazard models were used to control for covariates, reporting hazard ratios (HRs). Patients who had not yet reached clinical remission were censored at data capture. Subgroup comparisons were made for UPA vs TNFis and other ATs excluding TNFis. Results GIs reported data on 281 patients with UC treated with UPA and 1061 patients with UC treated with other ATs (Table 1). Patients treated with UPA had significantly faster time to remission compared to other ATs (P = 0.0001), with median (95% confidence interval [CI]) time to remission for UPA of 4.4 (3.5, 5.8) months compared to 6.9 (6.0, 7.8) months for other ATs (Figure 1). This remained significant after adjusting for covariates (adjusted HR [aHR]: 1.58, P = 0.0002). Subgroup analysis showed that UPA also had significantly faster median time to remission compared to anti-TNFis alone (6.9 [CI 5.9, 8.9], P < 0.0001), as well as all other ATs except anti-TNFis (6.7 [CI 5.7, 7.9], P = 0.0015). These remained significant after adjusting for covariates (aHR 1.66, P = 0.0003 and aHR 1.46, P = 0.0025). Conclusion In a global, real-world setting, patients receiving UPA achieved clinical remission approximately 3 months faster compared to those receiving other ATs, highlighting the effectiveness of UPA treatment for moderate-to-severe UC. Faster remission may contribute to improved quality of life and reduced corticosteroid use or resource burden. Conflict of interest: Seidelin, Jakob Benedict: JS has received research grants from Takeda and Janssen, and is a national coordinator of studies from AbbVie, Arena Pharmaceuticals, Ely Lilly, and Boehringer Ingelheim. Marín-Jiménez, Ignacio: IMJ has served as a speaker, a consultant and advisory member for or has received research funding from AbbVie, Amgen, Chiesi, Dr. Falk Pharma, Faes Farma, Ferring, Fresenius, Galapagos, Gebro Pharma, Janssen, Kern Pharma, Lilly, MSD, Otsuka Pharmaceutical, Pfizer, Sandoz, Shire Pharmaceuticals, Takeda, Tillotts Pharma, and Vifor Pharma. Dawod, Fatima: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Barlow, Sophie: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Lukanova, Rina: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Jones, William: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Sharma, Dolly: Employee of AbbVie and may own stock or options. Morisset, Pierre: Employee of AbbVie and may own stock or options. Kim, Jae: Employee of AbbVie and may own stock or options. Siegel, Corey: Consultant/Advisory Board: Abbvie, Boomerang, Celltrion, Johnson and Johnson, Lilly, Napo Pharmaceuticals, Path Healthcare, Pfizer, Prometheus Labs, Sanofi, Takeda, Trellus Health Speaker for CME activities: Abbvie, Johnson & Johnson, Pfizer, Takeda Grant support: Abbvie, Celltrion, Johnson & Johnson, Lilly, Pfizer Intellectual property: MiTest Health, LLC (software company) has a patent for a “System and Method of Communicating Predicted Medical Outcomes.” Equity Interest: Dr. Corey Siegel and Dr. Lori Siegel are co-founders of MiTest Health, LLC (software company). Technology developed by MiTest Health, LLC has been licensed to Takeda. Dr. Corey Siegel has an equity interest in Path Healthcare. Dr. Corey Siegel has an equity interest in Trellus Health