Effect of Tofacitinib on One-Year Colectomy Risk in Anti-TNF Refractory Ulcerative Colitis: A Prospective Multicenter...

Area of Science:

• Gastroenterology
• Immunology
• Pharmacology

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
• Tofacitinib is an oral Janus kinase inhibitor for UC treatment.
• Many patients do not respond to anti-TNF therapies.

Purpose of the Study:

• Assess tofacitinib's effectiveness and safety in UC patients with prior anti-TNF failure.
• Evaluate outcomes at 52 weeks in a real-world setting.
• Identify factors associated with colectomy.

Main Methods:

• Prospective multicenter study from January 2021 to March 2023.
• Included 58 adult patients with moderate-to-severe UC after anti-TNF failure.
• Assessed colectomy rates, clinical/endoscopic remission, response, and adverse events at 52 weeks.

Main Results:

• Only 10.3% of patients underwent colectomy.
• At 52 weeks, 53.4% achieved clinical remission, 43.1% clinical response, and 48.3% steroid-free remission.
• 50% of patients with colonoscopies achieved endoscopic remission; 24.1% experienced adverse events, with only 3.4% discontinuing treatment.

Conclusions:

• Tofacitinib is effective for anti-TNF refractory UC patients.
• It prevents colectomy and induces clinical and endoscopic remission at 52 weeks.
• The treatment demonstrates a good safety profile in real-world use.