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.
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.
Authors: David T Rubin; Ashwin N Ananthakrishnan; Corey A Siegel; Bryan G Sauer; Millie D Long Journal: Am J Gastroenterol Date: 2019-03 Impact factor: 10.864
Authors: William J Sandborn; Julián Panés; Geert R D'Haens; Bruce E Sands; Chinyu Su; Michele Moscariello; Thomas Jones; Ron Pedersen; Gary S Friedman; Nervin Lawendy; Gary Chan Journal: Clin Gastroenterol Hepatol Date: 2018-11-23 Impact factor: 11.382
Authors: William J Sandborn; Chinyu Su; Bruce E Sands; Geert R D'Haens; Séverine Vermeire; Stefan Schreiber; Silvio Danese; Brian G Feagan; Walter Reinisch; Wojciech Niezychowski; Gary Friedman; Nervin Lawendy; Dahong Yu; Deborah Woodworth; Arnab Mukherjee; Haiying Zhang; Paul Healey; Julian Panés Journal: N Engl J Med Date: 2017-05-04 Impact factor: 91.245
Authors: David T Rubin; Dezheng Huo; Jami A Kinnucan; Mina S Sedrak; Nicole E McCullom; Alana P Bunnag; Elin P Raun-Royer; Russell D Cohen; Stephen B Hanauer; John Hart; Jerrold R Turner Journal: Clin Gastroenterol Hepatol Date: 2013-07-17 Impact factor: 11.382
Authors: Roni Weisshof; Maya Aharoni Golan; Philip H Sossenheimer; Katia El Jurdi; Jacob E Ollech; Joel Pekow; Russel D Cohen; Atsushi Sakuraba; Sushila Dalal; David T Rubin Journal: Dig Dis Sci Date: 2019-02-07 Impact factor: 3.487