Safety and Efficacy of Tofacitinib in Combination With Biologic Therapy for Refractory Crohn's Disease.
Background The majority of patients with Crohn's disease (CD) will not achieve endoscopic remission on current therapy. Addition of tofacitinib to biologics may improve remission rates. Methods We retrospectively assessed safety and clinical and endoscopic effectiveness of off-label tofacitinib and...
| Publicado en: | Inflammatory Bowel Diseases Vol. 28; no. 2; pp. 309 - 314 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Feb2022
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155606100&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155606100 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10780998 N0V jtl: Inflammatory Bowel Diseases issn: 10780998 maglogo: N pubinfo: dt: Feb2022 vid: 28 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 155606100 155606100 155606100 10.1093/ibd/izab176 155606100 ppf: 309 ppct: 5 formats: tig: atl: Safety and Efficacy of Tofacitinib in Combination With Biologic Therapy for Refractory Crohn's Disease. aug: au: Lee, Scott David Singla, Anand Harper, Jason Barahimi, Mitra Jacobs, Jeffrey Kamp, Kendra J Clark-Snustad, Kindra Dawn affil: University of Washington, Division of Gastroenterology , Seattle, Washington , USA sug: subj: Antibodies, Monoclonal Therapeutic Use Janus Kinase Inhibitors Therapeutic Use Drug Therapy, Combination Methods Crohn Disease Therapy Drug Efficacy Evaluation Treatment Outcomes Evaluation Janus Kinase Inhibitors Adverse Effects Antibodies, Monoclonal Adverse Effects Drug Therapy, Combination Adverse Effects Colonoscopy Drugs, Off-Label Therapeutic Use Antiinflammatory Agents Therapeutic Use Gastrointestinal Agents Therapeutic Use Human Retrospective Design Pyoderma Gangrenosum Drug Therapy Adult Middle Age Treatment Duration Descriptive Statistics Disease Remission Severity of Illness Indices Wound Healing Clinical Assessment Tools Adult: 19-44 years Middle Aged: 45-64 years ab: Background The majority of patients with Crohn's disease (CD) will not achieve endoscopic remission on current therapy. Addition of tofacitinib to biologics may improve remission rates. Methods We retrospectively assessed safety and clinical and endoscopic effectiveness of off-label tofacitinib and biologics for CD. Results We identified 19 patients treated with tofacitinib and a biologic for refractory CD between 2017 and 2019. Tofacitinib was added for luminal disease on colonoscopy (n = 13), luminal disease on capsule (n = 3), and pyoderma gangrenosum (n = 3). The mean age was 41.2 years (28–62), mean disease was duration 16.9 years (6–36), and prior exposure to biologics was a median of 4 (1–6). Mean treatment duration was 9.6 months (SD, 3.3). Adverse events (AEs) were reported in 36.8% of patients, most commonly minor infection or CD flare, and no patients had a serious AE; 80.0% (n = 8) achieved clinical response, and 60.0% (n = 6) achieved clinical remission based on Harvey-Bradshaw Index. Endoscopic improvement occurred in 54.5% (n = 6), endoscopic remission in 18.2% (n = 2), and endoscopic healing in 18.2% (n = 2) of patients. Mean Simple Endoscopic Score in CD significantly improved from 13.6 ± 5.2 to 6.5 ± 4.0 after treatment (P <.01). Conclusions In patients treated with tofacitinib in combination with a biologic, no new safety signals were observed. Combination tofacitinib and a biologic was effective in achieving clinical and endoscopic improvement in some patients with severe, refractory CD, although a larger sample size is needed to further assess the efficacy and long-term safety of this treatment strategy. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|