Ulcerative colitis: tofacitinib can benefit patients after other treatments fail

  • Lair-Mehiri L & al.
  • Dig Liver Dis
  • 12.11.2019

  • von Craig Hicks
  • Clinical Essentials
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Takeaway

  • Patients with moderate to severe active ulcerative colitis (UC) can achieve clinical remission when treated with the oral Janus kinase inhibitor tofacitinib (Xeljanz) after not responding to treatment with anti-TNF agents or vedolizumab.

Why this matters

  • These findings affirm phase 3 trial results demonstrating the effectiveness and safety of tofacitinib, but in a real-world setting.

Study design

  • Researchers studied consecutive patients with active UC treated with tofacitinib (N=38; women, 39%; median age, 41 [range, 28-52] years; median follow-up, 41.5 weeks) after unsuccessful treatment with anti-TNF agents or vedolizumab.
  • Study outcomes included survival without colectomy, survival without tofacitinib discontinuation, and steroid-free clinical remission and clinical response at weeks 14, 24, and 48.
  • Funding: None disclosed.

Key results

  • 77.1% (95% CI, 59.3%-87.9%) of patients achieved survival without colectomy at week 24 and 70% (95% CI, 50.9%-82.8%) at week 48.
  • 70.2% (95% CI, 52.6%-82.3%) of patients achieved survival without treatment discontinuation at week 24.
  • 34.2% of patients achieved steroid-free clinical remission at week 48.
  • Adverse events occurred in 37% of patients, including 6 severe adverse events and 3 herpes zoster infections.

Limitations

  • The study was retrospective, with a small sample size.