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Dig Dis Sci. 2019 Jul;64(7):1945-1951. doi: 10.1007/s10620-019-05492-y. Epub 2019 Feb 7.

Real-World Experience with Tofacitinib in IBD at a Tertiary Center.

Author information

1
Inflammatory Bowel Disease Center, University of Chicago Medicine, 5841 S. Maryland Ave, MC 4076, Chicago, IL, 60637, USA.
2
Inflammatory Bowel Disease Center, University of Chicago Medicine, 5841 S. Maryland Ave, MC 4076, Chicago, IL, 60637, USA. drubin@uchicago.edu.

Abstract

BACKGROUND AND AIMS:

Many inflammatory bowel disease (IBD) patients do not respond to medical therapy. Tofacitinib is a first-in-class, partially selective inhibitor of Janus kinase, recently approved for treating patients with ulcerative colitis (UC). We describe our experience with the use of tofacitinib for treatment of patients with moderate-to-severe IBD.

METHODS:

This is a retrospective, observational study of the use of tofacitinib in IBD. Patients with medically resistant IBD were treated orally with 5 mg or 10 mg twice daily. Clinical response and adverse events were assessed at 8, 26, and 52 weeks. Objective response was assessed endoscopically, radiologically, and biochemically.

RESULTS:

58 patients (53 UC, 4 Crohn's, 1 pouchitis) completed at least 8 weeks of treatment with tofacitinib. 93% of the patients previously failed treatment with anti-TNF. At 8 weeks of treatment, 21 patients (36%) achieved a clinical response, and 19 (33%) achieved clinical remission. Steroid-free remission at 8 weeks was achieved in 15 patients (26%). Of the 48 patients followed for 26 weeks, 21% had clinical, steroid-free remission. Of the 26 patients followed for 12 months, 27% were in clinical, steroid-free remission. Twelve episodes of systemic infections were noted, mostly while on concomitant steroids. One episode of herpes zoster infection was noted during follow-up.

CONCLUSIONS:

In this cohort of patients with moderate-to-severe, anti-TNF resistant IBD, tofacitinib induced clinical response in 69% of the patients. 27% were in clinical, steroid-free remission by 1 year of treatment. Tofacitinib is an effective therapeutic option for this challenging patient population.

KEYWORDS:

Inflammatory bowel disease; Jak inhibitors; Tofacitinib; Ulcerative colitis

PMID:
30734234
DOI:
10.1007/s10620-019-05492-y

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