Upadacitinib (Rinvoq) demonstrated sustained clinical benefit at 1 year in children and adolescents with inflammatory bowel disease (IBD) in a single-center retrospective study involving 48 patients.[usercontent] In a multicenter retrospective study, 100 children (90 with ulcerative colitis and 10 with IBD-U, median age 15.6 years) achieved a clinical response after 8 weeks of induction 84%, clinical remission in 62% and corticosteroid-free remission in 56% of patients.[1] Normal levels of C-reactive protein reached 75% and fecal calprotectin below 150 mcg/g 50% of children.[1] Combined remission without corticosteroids and with normal fecal calprotectin was in 39% of 46 patients with available data.[1] Adverse events were recorded in 37 children, including 1 serious event – neuroendocrine tumor of the appendix; the most common were hyperlipidemia (13 cases), acne (12) and infections (10, including 5 herpes viruses).[1] The study confirms upadacitinib as an effective induction therapy in refractory pediatric ulcerative colitis and IBD-U, considering the risks of adverse events.[1]