Abstract
Upadacitinib (UPA) is a selective JAK-1 inhibitor used in the treatment of ulcerative colitis (UC) and Crohn's disease. We report a real-world retrospective study evaluating the efficacy and safety of UPA in 17 patients who scaled from mild to severe UC, and demonstrated significant improvement in Inflammatory biomarkers, with the majority (16/17 patients) achieving reduced fecal calprotectin levels. Three patients had subsequent endoscopic evaluation after being initiated on UPA; two showed improvement in the Mayo score, and the remaining patient remained static. The side effect profile was consistent with known JAK inhibitor effects, with elevated cholesterol as the most common adverse event, and one case of neutropenia was observed. These findings suggest that UPA is an effective therapeutic option for refractory UC patients, and further studies would help in confirming its long-term efficacy in these patients.