Initial Experience of Tofacitinib for the treatment of Moderate to Severe Ulcerative Colitis in the South Eastern Trust
R Howard, N Maybin, P Allen
Gastroenterology Department, Ulster Hospital
Tofacitinib has recently been approved by National Institute for Health and Care Excellence (NICE) as an option for treating moderate to severe Ulcerative Colitis (in adults) when conventional therapy or a biological agent cannot be tolerated or the disease has responded inadequately or lost response to treatment. It is the first oral, small molecule Janus Kinase inhibitor approved for treatment of UC.
To review our initial experience using Tofacitinib in real world clinical setting. From December 2018 until August 2019 10 patients in the South Eastern trust have commenced Tofacitinib.
We performed a retrospective analysis of patients using electronic care record and phone interview with patients to assess current Partial Mayo Score and assess for any adverse events.
At time of submission our patients had been on Tofacitinib for cumulative duration of 48 months ( range 2-9months). Three (30%) were in clinical remssion ( Partial Mayo 0-1). 5 (50%) had clinical response (improvement of Partial Mayo by 3 points) Two (20%) patients required colectomy, Other than the two patients requiring surgery, the other 8 patients remained on Tofacitininb. There were no serious adverse events. There were no cases of pulmonary embolism and no Herpes Zoster infections reported in our cohort.
Our initial experience of Tofacitinib has shown the drug to be well tolerated and with promising response rates. Potential benefits are early onset of action seen in Phase 3 trials and its oral route. More evidence is required to determine position of Tofacitinib in treatment of Ulcerative Colitis.