Efficacy and safety of tofacitinib in the treatment of ulcerative colitis: real-life experience in Andalusia.

Autor:	Hernández Martínez A; Digestivo, Hospital Universitario Torrecárdenas, España., Navajas Hernández P; Digestivo, Hospital Universitario Virgen Macarena., Martín Rodríguez MDM; Digestivo, Hospital Universitario Virgen de las Nieves., Lázaro Sáez M; Digestivo, Hospital Universitario Torrecárdenas., Olmedo Martín R; Digestivo, Hospital Regional Universitario Carlos Haya., Núñez Ortiz A; Digestivo, Hospital Universitario Virgen del Rocío, España., Argüelles Arias F; Digestivo, Hospital Universitario Virgen Macarena., Fernández Cano MC; Digestivo, Hospital Universtiario Virgen de las Nieves, España., Gallardo Sánchez F; Digestivo, Hospital de Poniente., Marín Pedrosa S; Digestivo, Hospital Universitario Reina Sofía., González García J; Digestivo, Hospital La Inmaculada, España., Vázquez Morón JM; Digestivo, Hospital Universitario Juan Ramón Jiménez.
Jazyk:	angličtina
Zdroj:	Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva [Rev Esp Enferm Dig] 2022 Sep; Vol. 114 (9), pp. 516-521.
DOI:	10.17235/reed.2022.8380/2021
Abstrakt:	Background: tofacitinib is a Janus kinase inhibitor approved for the treatment of moderate-severe ulcerative colitis (UC). This study aimed to evaluate its efficacy in a real-life setting. Methods: a retrospective and multicenter observational study was performed with UC patients treated with tofacitinib. Short and long-term treatment effectiveness, treatment survival, need for dose escalation and safety were analyzed. Clinical response and remission were defined in accordance with the partial Mayo score. Results: seventy-four patients were included, 98.3 % had received prior biological treatment, 55.4 % with three or more biologicals and up to 64.9% with two or three different mechanisms of action. Clinical remission and response rates were 37.8 % and 77 % at eight weeks, and 41.8 % and 70.1 % at 16 weeks. With regard to non-responders at eight weeks, 37.5 % achieved a delayed clinical response at 16 weeks. Mean treatment duration was 19 months (95 % CI: 16-22), with a treatment survival of 56 % at 28 months, and remission and response rates at 24 months of 53.8 % and 61.5 %. Twenty-three treatments were withdrawn, most of them (18) during the induction period. There were adverse events in a quarter of the patients; only four were severe and led to treatment discontinuation. Conclusion: tofacitinib has a demonstrated efficacy in clinical practice to induce and maintain clinical response in treatment-refractory UC patients, with an acceptable safety profile.
Databáze:	MEDLINE
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