Tofacitinib in the treatment of moderate to severe ulcerative colitis in Colombia: Real world experience

• Published in: Gastroenterología y hepatología Vol. 46; no. 7; p. 512
• Main Authors: Parra-Izquierdo, Viviana, Frías-Ordoñez, Juan Sebastián, Márquez, Juan Ricardo, Juliao-Baños, Fabián, Galindo, Pablo, Cuadros, Carlos, Rojas, Carlos, Rojas, Nelson, Ardila, Oscar, Tovar-Fierro, German, García-Duperly, Rafael, Vargas, Melquicedec, Flórez-Sarmiento, Cristian
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-08-2023
• Subjects: Adolescent; Adult; Aged; Child; Colitis - drug therapy; Colitis, Ulcerative - chemically induced; Colitis, Ulcerative - drug therapy; Colombia; Female; Humans; Male; Middle Aged; Piperidines - adverse effects; Piperidines - therapeutic use; Treatment Outcome; Young Adult; Colombia; Enfermedades inflamatorias del intestino; Inflammatory bowel diseases; Tofacitinib; Janus kinase inhibitors; Terapéutica; Therapeutics; Inhibidores de las cinasas Janus; Colitis ulcerosa; Manejo de la enfermedad; Disease management; Ulcerative colitis
• DOI: 10.1016/j.gastrohep.2022.10.020
• ISSN: 0210-5705

There are no studies on efficacy of tofacitinib for ulcerative colitis (UC) in Latin America. The aim of this study was to describe the efficacy and safety, in the real world, of patients with moderate-severe UC treated with tofacitinib in our setting.
Multicenter descriptive observational study, in patients with UC who received treatment with tofacitinib in induction phase for 8 weeks and then, maintenance therapy, between June 2019 and June 2022.
Thirty-four adult patients, 50% female, mean age 38.1 (range 22-72) years. 76.5% pancolitis, and 20.6% left colitis. 79.4% failure to tumor necrosis factor inhibitors (anti-TNFs), and 35.3% to vedolizumab. 14.7% naïve to biologic therapy. 23.5% had previous extraintestinal manifestations. During induction, 58.8% of patients achieved clinical, biochemical and endoscopic remission. During maintenance, 76.9% of patients at 26 weeks and 66.6% at 52 weeks presented clinical remission. Eight patients presented adverse events, none of them cardiovascular or thromboembolic. 44.1% were steroid-dependent, and 23.5% required steroids as rescue therapy. 38.3% required an increase in tofacitinib to 10mg every 12h during maintenance. In 17.6% tofacitinib was discontinued due to lack of efficacy. We included three pediatric-aged female patients, mean age 15.3 (range 14-17) years, 2/3 with pancolitis and 1/3 with left colitis, all with prior exposure to biologic therapy, who had clinical, biologic and endoscopic remission at induction.
In this first Latin American study with tofacitinib in UC, efficacy and safety are demonstrated in the treatment of our patients with moderate to severe activity.