Real-world experience with Janus kinase inhibitors in extraintestinal manifestations and inflammatory bowel disease in Colombia: A comparative study (JAKEIM-IBD Study)

Sep 30, 2026

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Extraintestinal manifestations (EIMs) substantially affect patients with inflammatory bowel disease (IBD), influencing quality of life and clinical complexity. This multicenter real-world study evaluates Colombian patients with moderate-to-severe IBD and EIMs treated with upadacitinib or tofacitinib, assessing prevalence, resolution, and progression of EIMs. Among 77 patients, most EIMs were articular; induction response and maintenance remission were reported, with no significant difference in remission rates between treatments. Adverse events included alopecia, acne, and herpes zoster.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Highlights

Upadacitinib and tofacitinib outcomes

Safety profile and remission

Study context in Colombia

Abstract

Background and objectives

Methods

Results

Adverse events

Conclusion

Keywords

Introduction

Challenge of EIMs in IBD

Current therapies and variability in response

Emerging treatments and guideline gaps

ORIGINAL ARTICLE INFLAMMATORY DISEASE HIGHLIGHTS • Upadacitinib and tofacitinib effectively controlled EIMs and reduced corticosteroid dependence. • Safety profile was favorable, with mainly mild infections and herpes zoster. • JAK inhibitors represent effective and safe options for IBD with extraintestinal involvement. • Both agents achieved sustained remission of extraintestinal manifestations during maintenance therapy. Received: 30 March 2025 Accepted: 29 August 2025 Declared conflict of interest of all authors: none Disclosure of funding: none Declaration of use of artificial intelligence: none Data availability statement: Not applicable – The study did not use research data Corresponding Author: Juan Sebastian Frías-Ordoñez. E-mail: [jsfriaso@unal.edu.co](jsfriaso@unal.edu.co). Associate editor: José Miguel L. Parente [doi.org/10.1590/S0004-2803.24612025-045](doi.org/10.1590/S0004-2803.24612025-045) Real-world experience with Janus kinase inhibitors in extraintestinal manifestations and inflammatory bowel disease in Colombia: A comparative study (JAKEIM-IBD Study) Viviana PARRA-IZQUIERDO1,2 , Oscar ARDILA3 , Juan Ricardo MÁRQUEZ4 , Javier RIVEROS5 , Álvaro Andrés GÓMEZ-VENEGAS6 , Carlos Andrés MEDRANO-ALMANZA7 , Manuel BALLESTEROS8 , Jonathan BARRETO-PÉREZ9 and Juan Sebastian FRIAS-ORDOÑEZ10 1 Hospital Internacional de Colombia, Gastroenterology and Rheumatology, Bucaramanga, Colombia. 2 El Bosque University, Cellular and Molecular Immunology Group-InMuBo, Bogota, Colombia. 3 CES Clinic, Gastroenterology, Medellín, Colombia. 4 Instituto ICO, Coloproctology, Medellin, Colombia. 5 Clínica de La Mujer, Gastroenterology, Bogotá, Colombia. 6 Private practice, Gastroenterology, Medellin, Colombia. 7 Gastroadvanced IPS, Gastroenterology, Medellin, Colombia. 8 Intergastro, Gastroenterology, Medellin, Colombia. 9 Medicarte, Gastroenterology, Bogota, Colombia. 10 Hospital Internacional de Colombia, Gastroenterology, Bucaramanga, Colombia. ABSTRACT–Background–Extraintestinal manifestations (EIMs) significantly impact patients with inflammatory bowel disease (IBD). Janus kinase inhibitors (JAKi) are emerging as a potential treatment. This study describes real-world outcomes in Colombian patients with IBD and EIMs treated with upadacitinibor tofacitinib. Methods–Multicenter study including moderate-to-severe IBD patients with EIMs. We analyzed the prevalence, resolution, and progression of EIMs with JAKi therapy. Results – Among 77 patients (51 UC-tofacitinib, 16 UC-upadacitinib, 10 CD-upadacitinib), 28.6%(n=22) had EIMs, primarily articular (81.25%), followed by hepatobiliary (25%), cutaneous (18.75%), and ocular (6 .25%) . Most tofacitinib-UC patients (90%) had prior anti-TNF therapy. During induction, 66.6% had a clinical response, and 33.3% achieved EIM remission. In maintenance, 83.3% achieved remission. Among upadacitinibUC patients, 66.6% had prior anti-TNF, 33.3% anti-integrin, and 33.3% were biologic-naïve. Corticosteroid use was reduced in 66.7% . Induction response was 66.7%, with 33.3% achieving remission. At six months, remission was 50% . No significant difference in remission rates was observed between upadacitinib and tofacitinib (OR 1.36, 95%CI 0.43-4.33, P=0 .28) . In CD-upadacitinib, all patients had prior anti-TNF therapy, with 66.6% achieving remission during induction. Adverse events included alopecia, acne, and herpes zoster. Conclusion–JAKi therapy is a safe and effective alternative for IBD patients with EIMs. While upadacitinib may offer superior intestinal benefits, both treatments demonstrated efficacy in managing EIMs. Keywords – Extraintestinal manifestations; janus kinase inhibitors; inflammatory bowel diseases; therapy; therapeutics; disease management; drug-related side effects and adverse reactions. Arq Gastroenterol • 2025. v. 62:e25045 113 Real-world experience with Janus kinase inhibitors in extraintestinal manifestations and inflammatory bowel

FAQs

What was the main aim of the JAKEIM-IBD Study?

To describe real-world outcomes in Colombian patients with IBD and extraintestinal manifestations treated with upadacitinib or tofacitinib, including prevalence, resolution, and progression of EIMs.

What types of extraintestinal manifestations were most common?

Articular manifestations were most frequent (81.25%), followed by hepatobiliary (25%), cutaneous (18.75%), and ocular (6.25%).

Were remission outcomes different between upadacitinib and tofacitinib?

No significant difference in remission rates was observed between upadacitinib and tofacitinib (OR 1.36, 95% CI 0.43-4.33, P=0.28).

Sep 30, 2026

Uploaded by dawugda