Endo-histologic Normalization Is Achievable with Tofacitinib and Is Associated with Improved Clinical Outcomes
Background Recent real-world effectiveness studies investigating tofacitinib have been encouraging. Questions remain regarding the long-term effectiveness and safety of tofacitinib, effect on endoscopic remission rates, histologic changes, and alterations in fecal calprotectin levels. Methods This retrospective study includes consecutive patients with inflammatory bowel disease (IBD) who initiated tofacitinib therapy. We reviewed electronic medical records for demographic and clinical data, as well as all adverse events and hospitalizations. All patients receiving tofacitinib were included in the safety analysis and only patients with ulcerative colitis (UC) were included in the effectiveness analysis. Results 119 patients with IBD (97 UC, 12 CD, and 10 pouchitis) seen at our center between 2014 and 2020 were included in this study. Median follow-up was 32 weeks (interquartile range (IQR) 3–252). Clinical response and remission were observed in 70% and 21%, 59% and 33%, and 49%, and 37% at weeks 8, 24, and 52, respectively. Endo-histologic healing was achieved by 11%, 25%, and 37.5% of patients at weeks 8, 24, and 52, respectively. Histologic normalization occurred as early as 24 weeks in this cohort and was achieved by 26% of patients in endoscopic remission. Overall, there were 27 (25%) adverse events with 6 (5%) resulting in treatment discontinuation. There were 11 (10%) infections, none required treatment discontinuation. Ten (10.3%) patients underwent colectomy during the follow-up period. There were no cardiovascular adverse events in the cohort during follow-up. Conclusion This study demonstrates the effectiveness and long-term safety of tofacitinib in patients with UC. Importantly, we show that the endpoint of endo-histologic healing is achievable with tofacitinib and can occur as early as week 8 of therapy..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
|---|---|
| Enthalten in: |
Digestive diseases and sciences - 68(2022), 4 vom: 15. Okt., Seite 1464-1472 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cohen, Nathaniel A. [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
|---|
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
|---|
| doi: |
10.1007/s10620-022-07716-0 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2134433205 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2134433205 | ||
| 003 | DE-627 | ||
| 005 | 20230510161649.0 | ||
| 007 | tu | ||
| 008 | 230510s2022 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10620-022-07716-0 |2 doi | |
| 035 | |a (DE-627)OLC2134433205 | ||
| 035 | |a (DE-He213)s10620-022-07716-0-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 100 | 1 | |a Cohen, Nathaniel A. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Endo-histologic Normalization Is Achievable with Tofacitinib and Is Associated with Improved Clinical Outcomes |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Background Recent real-world effectiveness studies investigating tofacitinib have been encouraging. Questions remain regarding the long-term effectiveness and safety of tofacitinib, effect on endoscopic remission rates, histologic changes, and alterations in fecal calprotectin levels. Methods This retrospective study includes consecutive patients with inflammatory bowel disease (IBD) who initiated tofacitinib therapy. We reviewed electronic medical records for demographic and clinical data, as well as all adverse events and hospitalizations. All patients receiving tofacitinib were included in the safety analysis and only patients with ulcerative colitis (UC) were included in the effectiveness analysis. Results 119 patients with IBD (97 UC, 12 CD, and 10 pouchitis) seen at our center between 2014 and 2020 were included in this study. Median follow-up was 32 weeks (interquartile range (IQR) 3–252). Clinical response and remission were observed in 70% and 21%, 59% and 33%, and 49%, and 37% at weeks 8, 24, and 52, respectively. Endo-histologic healing was achieved by 11%, 25%, and 37.5% of patients at weeks 8, 24, and 52, respectively. Histologic normalization occurred as early as 24 weeks in this cohort and was achieved by 26% of patients in endoscopic remission. Overall, there were 27 (25%) adverse events with 6 (5%) resulting in treatment discontinuation. There were 11 (10%) infections, none required treatment discontinuation. Ten (10.3%) patients underwent colectomy during the follow-up period. There were no cardiovascular adverse events in the cohort during follow-up. Conclusion This study demonstrates the effectiveness and long-term safety of tofacitinib in patients with UC. Importantly, we show that the endpoint of endo-histologic healing is achievable with tofacitinib and can occur as early as week 8 of therapy. | ||
| 650 | 4 | |a Ulcerative colitis | |
| 650 | 4 | |a Tofacitinib | |
| 650 | 4 | |a Histology | |
| 650 | 4 | |a Safety | |
| 700 | 1 | |a Steinberg, Joshua M. |4 aut | |
| 700 | 1 | |a Silfen, Alexa |4 aut | |
| 700 | 1 | |a Traboulsi, Cindy |4 aut | |
| 700 | 1 | |a Rodriguez, Tina G. |4 aut | |
| 700 | 1 | |a Singer, Jorie M. |4 aut | |
| 700 | 1 | |a Patel, Shivani |4 aut | |
| 700 | 1 | |a Cohen, Russell D. |4 aut | |
| 700 | 1 | |a Dalal, Sushila R. |4 aut | |
| 700 | 1 | |a Sakuraba, Atsushi |4 aut | |
| 700 | 1 | |a Pekow, Joel |4 aut | |
| 700 | 1 | |a Micic, Dejan |4 aut | |
| 700 | 1 | |a Rubin, David T. |0 (orcid)0000-0001-5647-1723 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Digestive diseases and sciences |d Springer US, 1979 |g 68(2022), 4 vom: 15. Okt., Seite 1464-1472 |w (DE-627)129894036 |w (DE-600)304250-9 |w (DE-576)015213218 |x 0163-2116 |7 nnns |
| 773 | 1 | 8 | |g volume:68 |g year:2022 |g number:4 |g day:15 |g month:10 |g pages:1464-1472 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s10620-022-07716-0 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 951 | |a AR | ||
| 952 | |d 68 |j 2022 |e 4 |b 15 |c 10 |h 1464-1472 | ||