Abstract
Paediatric-onset inflammatory bowel disease (IBD) has an enormous impact on healthcare systems as it translates to a lifetime of healthcare. Since the approval of anti-tumour necrosis factor-alpha agents, it has become evident that in the long journey of paediatric IBD, there is an absolute need for more treatment options. Emerging evidence from the adult literature suggests that upadacitinib is effective and safe; however, paediatric data are scarce. We present two adolescents with highly refractory to treatment Crohn's disease. One of them had undergone subtotal colectomy. Both patients were treated effectively with upadacitinib.