Upadacitinib Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis for Ulcerative Colitis Achieved Ulcer Healing for Pyoderma Gangrenosum

Satoshi Tanida, Ryoji Kubo, Shoichiro Yoshii, Takuya Takahama, Shun Sasoh, Yoshimasa Kubota, Tesshin Ban, Tomoaki Ando, Makoto Nakamura, Takashi Joh


A 44-year-old woman who had been diagnosed with ulcerative colitis (UC) at 22 years old was diagnosed with severe flare-up of UC based on endoscopic findings associated with new-onset active pyoderma gangrenosum (PG) on both lower legs after she decided to discontinue UC treatment. Systemic treatment with intravenous prednisolone at 30 mg/day had achieved insufficient response to UC and PG, resulting in a diagnosis of corticosteroid-refractory UC and PG. Combination therapy with upadacitinib at 45 mg/day plus intensive granulocyte and monocyte adsorptive apheresis (GMA) was started to achieve clinical remission of UC. Ten weeks after starting this combination therapy, clinical improvement of UC was achieved with PG ulcer healing on both lower legs. A combination of upadacitinib plus intensive GMA may offer an effective therapeutic option for patients with active PG in addition to UC but has yet to be approved for induction or maintenance treatment of PG worldwide. PG is a dermatological involvement in UC patients that requires attention.

J Clin Med Res. 2023;15(10-11):446-455
doi: https://doi.org/10.14740/jocmr5005


Ulcerative colitis; New-onset pyoderma gangrenosum; Upadacitinib; Intensive granulocyte and monocyte adsorptive apheresis; Ulcer healing

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