What the trial was testing
The U-EXCEL enrolled 526 patients with crohn's disease. The study was sponsored by AbbVie and tracked outcomes across the full group of patients who matched the trial's eligibility profile.
It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.
What the results showed
About 50% reached clinical remission at 12 weeks — roughly twice the placebo rate.
New England Journal of Medicine · 2023 · NCT03345849
These findings — that of patients in clinical remission at 12 weeks on upadacitinib vs. placebo — were published in the New England Journal of Medicine and represent the headline result of the study.
Researchers tracked outcomes across 526 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.
What this means for patients
For patients with crohn's disease, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.
What you can do now
Upadacitinib (Rinvoq) is FDA-approved for moderately to severely active Crohn's disease in adults who haven't responded to other treatments and available now. It is taken as a once-daily pill — no injections or infusions. Side effects can include increased infection risk and lab changes; regular monitoring is required. Ask your gastroenterologist whether it fits.
Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.
Open crohn's disease trials
CEDATA GPGE - a Patient Registry for Children and Adolescents With Inflammatory Bowel Disease
CEDATA GPGE collects clinical data of children and adolescents with IBD from paediatric gastroenterology centers in german-speaking countries. Data is obtained from participating centers in pseudonymized way via an online platform at the beginning and during followup of the disease. The leading working group of the paediatric gastroenterology society GPGE e.V. includes 15 experts in the field who meet twice yearly and coordinate research and quality improvement initiatives.
Mesenteric Surgical Margin for Crohn's Disease Endoscopic Recurrence
Despite significant advancements in the treatment of Crohn's disease (CD), approximately 50% of patients undergo surgical intervention within ten years of diagnosis. Furthermore, more than 70% of these patients experience endoscopic recurrence within one year after surgery. This subset of patients often faces a poorer long-term prognosis and requires long-term intensified medical therapy. Therefore, reducing early postoperative endoscopic recurrence has remained a crucial focus in CD research. From a surgical perspective, there have been limited breakthroughs in improving surgical techniques to reduce the postoperative endoscopic recurrence rate in CD. Recent research indicates that microscopic inflammation at the cut edge of the CD bowel segment is a significant risk factor for postoperative endoscopic recurrence. Mesenteric wrapping is a unique clinical pathological feature of CD. Our retrospective data suggest a clear linear correlation between the degree of mesenteric wrapping and microscopic inflammation in the corresponding bowel segment. Surgical margins determined by mesenteric guidance significantly reduce the postoperative endoscopic recurrence rate and clinical relapse rate compared to the traditional 2 cm margin. However, there is currently no prospective study comparing the efficacy of these two surgical approaches.To address this, investigators plan to conduct a multicenter randomized controlled trial. This trial will focus on patients with ileocolonic CD who have undergone primary anastomosis without residual disease. investigators aim to compare the postoperative endoscopic recurrence rates between mesenteric-guided margins and the traditional 2 cm margins. Our goal is to determine whether mesenteric-guided margins can reduce the postoperative endoscopic recurrence rate and to conduct relevant mechanistic research. Ultimately, this research may lead to the development of a novel surgical approach for CD based on the findings of this study.