skip to main content

JAK inhibitor safety in ulcerative colitis — ESEGH MCQ

Instant feedback + full explanation. One question, done properly.

HardGI PharmacologyJAK inhibitor safety in ulcerative colitisESEGH

A 61-year-old man with ulcerative colitis is being considered for upadacitinib after anti-TNF failure. He had shingles 2 years ago and has not received recombinant zoster vaccine. Blood tests are stable and TB screening is negative. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Assess vaccination status and give indicated non-live vaccines before treatment where feasible

JAK inhibitors increase infection risk including herpes zoster, so vaccination status should be reviewed and indicated non-live vaccines given before treatment where possible. Live vaccines are generally avoided during significant immunosuppression. Normal TB screening does not remove vaccine-preventable risk. The pearl is that advanced IBD therapy requires preventive medicine as well as disease control.

Reference: BSG IBD Guideline 2025; BNF Upadacitinib; UKHSA Immunisation Guidance