Dual Targeted Therapy With Risankizumab and Upadacitinib in Refractory Ulcerative Colitis

Medically refractory acute severe ulcerative colitis (UC) remains a major therapeutic challenge. We describe a 39-year-old woman with multiple prior treatment failures who presented with a steroid-refractory UC flare. Given that she was symptomatic despite high-dose upadacitinib, dual targeted therapy with upadacitinib and risankizumab was initiated. The patient subsequently achieved rapid and sustained clinical remission with complete endoscopic and histologic mucosal healing. No serious adverse events were observed during 10 months of follow-up. This case highlights the potential role of dual targeted therapy with upadacitinib and risankizumab as a treatment strategy for selected patients with refractory severe UC.