IRISH SOCIETY OF GASTROENTEROLOGY / IRISH ASSOCIATION OF COLOPROCTOLOGY JOINT VIRTUAL WINTER MEETING 2020
ISG Winter Meeting 2019 Regular Posters Prize - Third Prize
St. Vincent’s University Hospital, Dublin
Real World Experience with Tofacitinib for Moderate to Severe Ulcerative Colitis (UC)
R SAEIDI, A YADAV, C ROWAN, G CULLEN, J SHERIDAN, E SLATTERY, L EGAN, A O’TOOLE, C O’MORAIN, GA DOHERTY
Centre for Colorectal Disease, St. Vincent’s University Hospital/UCD Medical School, UCHG and NUI Galway, Beaumont Hospital/RCSI, Trinity College Dublin/Beacon Hospital On behalf of the INITIative network
Tofacitinib, an oral pan-JAK inhibitor with short half-life, was recently approved for induction and maintenance of remission in UC. Tofacitinib has been linked to several adverse effects including higher infection risk, VZV re-activation, hyperlipidaemia and PE.
The aim of our study was to assess the safety and efficacy of tofacitinib in real world Irish practice.
We performed a retrospective multi-centre study through the INITIative IBD network. Anonymised demographic data was collected. Non-response was defined as permanent discontinuation due to lack of efficacy, need for colectomy or adverse effects.
Total of 18 patients were included with median therapy duration of 25 weeks, seventeen of which were on anti-TNF therapy prior to tofacitinib. Twelve (67%) were male. 12/18 patients (67%) responded to therapy, of which one discontinued therapy due to pregnancy. Median treatment duration was 31 weeks in responder group 6/18 (33%) patients were non-responders to therapy after a median of 17 weeks, 4 of whom underwent colectomy and 2 were referred for a surgical approach. 9/18 patients (50%) had concomitant maintenance medication(s); 2 of whom were on vedolizumab, 1 on methotrexate and the remainder on either oral 5-ASA or topical steroid/5-ASA, alone or in combination. There were 5 episodes of infection in 3 patients which required total of 38 days of therapy interruption. No other documented adverse effects of tofacitinib were recorded.
In our study majority of UC patients in real world Irish practice responded to tofacitinib. Further long term safety and efficacy registry of this medication would be beneficial.