Tofacitinib Effective both short-term and long-term in patients with Ulcerative Colitis

In a recent study published in the American Journal of Gastroenterology the efficacy, durability, and safety of tofacitinib in treating ulcerative colitis (UC) was thoroughly assessed, shedding light on its potential as a long-term treatment option for this debilitating condition.

The study, encompassing a comprehensive analysis of 408 UC patients who had been administered their first tofacitinib dose at least 8 weeks prior to inclusion, yielded significant insights into the drug's performance. The primary measure of clinical effectiveness was based on the partial Mayo score, a widely recognized index for assessing UC severity.

The study revealed that 45% of the patients discontinued tofacitinib during the follow-up period, which had an average duration of 18 months. The probability of maintaining tofacitinib usage stood at 67% after 6 months, 58% after 12 months, and 49% after 24 months. The leading cause of tofacitinib withdrawal was primary nonresponse, accounting for 44% of cases.

Factors influencing tofacitinib withdrawal were identified as older age at the commencement of treatment and a higher severity of clinical activity. Remission rates were encouraging, with 38% of patients achieving remission at week 4, rising to 47% by week 16. The likelihood of remission at week 8 was linked to the initial disease activity level and age at the onset of tofacitinib treatment.

Out of the patients who achieved remission at week 8, nearly half experienced a relapse, underlining the need for ongoing, long-term management strategies. The study demonstrated that maintaining response was probable for 66% of patients at 6 months and 54% at 12 months.

Safety considerations were also addressed in the study. Among the adverse events attributed to tofacitinib treatment, two cases of pulmonary thromboembolism and two instances of peripheral vascular thrombosis were noted. However, these incidents occurred in patients with pre-existing risk factors. Overall, the safety profile of tofacitinib remained consistent with previous reports.

Source:

Chaparro, M., Acosta, D., Rodríguez, C., Mesonero, F., Vicuña, M., Barreiro-de Acosta, M., Fernández-Clotet, A., Hernández Martínez, Á., Cabello Tapia, M. J., Muñoz Villafranca, C., Vázquez Morón, J. M., … Vicente Lidón, R. (2022). Real-World Evidence of Tofacinitib in Ulcerative Colitis: Short-Term and Long-Term Effectiveness and Safety. In American Journal of Gastroenterology (Vol. 118, Issue 7, pp. 1237–1247). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ajg.0000000000002145