Supplemental Material for: Effectiveness and Safety of Janus Kinase Inhibitors in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Real-world Studies

Summary

We conducted a systematic review and meta-analysis of real-world studies reporting outcomes in IBD patients treated with JAKis (tofacitinib, upadacitinib, or filgotinib). PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to August 11, 2025. Primary outcomes were clinical response and clinical remission; secondary outcomes included steroid-free clinical remission, endoscopic and biochemical responses, and safety outcomes. 63 studies involving 8130 IBD patients were included.

In ulcerative colitis (UC), pooled clinical response and remission rates were 55% and 43% for tofacitinib, 77% and 65% for upadacitinib, and 69% and 55% for filgotinib; steroid-free remission with tofacitinib approached 50% at 1 year. In Crohn’s disease (CD), upadacitinib achieved clinical response and remission in around two thirds of patients. For descriptive pooled safety outcomes, mortality was 0%; hospitalization and treatment discontinuation rates were 8% and 28% for tofacitinib, 5% and 12% for upadacitinib, and 4% and 15% for filgotinib; serious adverse events occurred in ≤8% of patients.</p><p dir="ltr">Key Messages: Descriptive real-world data show that tofacitinib, upadacitinib, and filgotinib all provide clinically meaningful effectiveness in UC and CD, with generally acceptable safety profiles.

This study provides a descriptive synthesis of real-world evidence, and further comparative studies are warranted to clarify the relative effectiveness and safety of individual JAKis.</p>