| Title: |
Effect of JAK inhibitors on extra-intestinal manifestations and concurrent immune-mediated inflammatory diseases in patients with inflammatory bowel disease. |
| Authors: |
Truyens, M.1,2; Tolstoy, X.3; Calabrese, G.4; Balestrieri, P.5; Argyriou, K.6; Blesl, A.7; Pouillon, L.8; Shakweh, E.9,10; Filip, R.11,12; Drygiannakis, I.13; Todeschini, A.14; Mocci, G.15; Pastras, P.16; Ribaldone, D. G.17,18; Jauregui-Amezaga, A.19,20; Moraleja-Yudego, I.21; Vieujean, S.22; Karmiris, K.23; Taelman, T.24,25; Kani, H. T.26 |
| Source: |
Journal of Crohn's & Colitis. 2026 Supplement, Vol. 20, pi2000-i2004. 5p. |
| Abstract: |
Background: Immune-mediated inflammatory diseases (IMIDs) and extra-intestinal manifestations (EIMs) are frequent in IBD and contribute substantially to morbidity. JAK inhibitors have demonstrated efficacy across several rheumatological IMIDs and emerging evidence suggests potential benefit in dermatological IMIDs such as atopic dermatitis. Additional real-world evidence is needed to guide their optimal positioning within IBD management. Methods: This multicentric retrospective cohort included adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) who initiated a JAK inhibitor (tofacitinib, upadacitinib or filgotinib) for IBD and had at least one EIM or IMID. IBD and EIM/IMID activity were assessed after induction (week 6–14), at month 6, and at month 12 using physician’s global assessment. IBD outcomes included clinical, biochemical and endoscopic remission. Treatment discontinuation due to primary non-response (PNR), loss of response (LOR) or surgery was classified as non-remission. The primary endpoint was EIM/IMID response while secondary endpoints included steroid-free IBD remission and new-onset of EIMs/IMIDs. Results: In total 214 patients were included (Table 1) with a median follow-up of 10 months (IQR 5-12). Steroid-free clinical remission was achieved in 38% post-induction and increased to 54% at 12 months (Figure 1). At baseline, axial and peripheral SpA were active in 72% and 80% of cases respectively; response rates reached 75% and 80% post-induction and remained 57% and 71% at 12 months. Psoriasis and hidradenitis suppurativa were active at baseline in 42% and 89% of patients, with response rates of 62% and 67% post-induction and decreasing to 40% and 50% at 12 months. Among 170 patients with available follow-up, seven (4.1%) developed new-onset EIMs/IMIDs, including peripheral SpA (n =3), oral CD manifestations (n=2) and one case each of pyoderma gangrenosum, axial SpA, primary sclerosing cholangitis and autoimmune hepatitis. Treatment was discontinued in 62 patients (29%) after a median of 5 months (IQR 2–10), mainly due to active IBD (PNR: n=14 (23%) or LOR: n=23 (37%)). Discontinuation due to worsening or new onset of EIMs/IMIDs occurred in 11 (18%) and 1 (2%) patient respectively. Conclusion: JAK inhibitors demonstrated effectiveness for IBD activity and associated EIMs/IMIDs, with particularly robust responses in peripheral SpA and more variable outcomes in dermatological manifestations. New-onset EIMs/IMIDs were uncommon. [ABSTRACT FROM AUTHOR] |
| Database: |
Supplemental Index |