Characteristics and Outcomes of IBD Patients with COVID-19 on Tofacitinib Therapy in the SECURE-IBD Registry

Agrawal, Manasi; Brenner, Erica J.; Zhang, Xian; Modesto, Irene; Woolcott, John; Ungaro, Ryan C.; Colombel, Jean–Frédéric; Kappelman, Michael D.

doi:10.1093/ibd/izaa303

Cited by 51 publications

(69 citation statements)

References 8 publications

(6 reference statements)

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“… 71 ), data from the SECURE-IBD registry (>4,000 cases) 72 confirmed corticosteroids (15%), rather than other drugs or general immunosuppression, as a key risk factor for intensive care unit treatment, ventilation or death. The anti-integrin antibody vedolizumab 73 – 76 was not associated with an increased risk for these endpoints (5%), while the IL-12 and IL-23 cytokine blocker ustekinumab 77 – 79 (2%), TNF blockers (2% versus 4% without or with methotrexate or thiopurine therapy), and the JAK1 and JAK3 blocker tofacitinib (3%) had the lowest risks 80 . Additional risk factors for intensive care unit treatment, ventilation or death in IBD were two or more comorbidities and age >60 years 80 .…”

Section: Immunosuppressants and Biologics In Ibdmentioning

confidence: 97%

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

Neurath

2021

Nat Rev Gastroenterol Hepatol

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The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health crisis causing major challenges for clinical care in patients with gastrointestinal diseases. Although triggering of anti-viral immune responses is essential for clearance of infection, some patients have severe lung inflammation and multiorgan failure due to marked immune cell dysregulation and cytokine storm syndrome. Importantly, the activation of cytotoxic follicular helper T cells and a reduction of regulatory T cells have a crucial, negative prognostic role. These findings lead to the question of whether immunosuppressive and biologic therapies for gastrointestinal diseases affect the incidence or prognosis of COVID-19 and, thus, whether they should be adjusted to prevent or affect the course of the disease. In this Review, data on the use of such therapies are discussed with a primary focus on inflammatory bowel disease, autoimmune hepatitis and liver transplantation. In particular, the roles of corticosteroids, classic immunosuppressive agents (such as thiopurines and mycophenolate mofetil), small molecules (such as Janus kinase (JAK) inhibitors), and biologic agents (such as tumour necrosis factor (TNF) blockers, vedolizumab and ustekinumab) are reviewed. Finally, the use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines for the prevention of infection in patients with gastrointestinal diseases and concomitant immunosuppressive or biologic therapy will be discussed.

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Section: Immunosuppressants and Biologics In Ibdmentioning

confidence: 97%

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

Neurath

2021

Nat Rev Gastroenterol Hepatol

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“…Despite that, her respiratory symptoms resolved in five days, and she recovered completely in two weeks with no change to tofacitinib treatment [7]. In addition, other studies have investigated the use of tofacitinib and other JAK inhibitors on the outcomes of COVID-19 infection and have concluded that there is no statistically significant difference in the rate of hospitalization, admission to the ICU, and severe COVID-19 infection among tofacitinib-treated patients and other patients [8,2]. In fact, a recently published systematic review sheds light on the potential efficacy of JAK inhibitors and Type I interferons against the COVID-19 infection and its association with positive clinical outcomes in terms of hospitalization, ICU admission, and mortality rate [9].…”

Section: Discussionmentioning

confidence: 99%

Tofacitinib Treatment in Patients With Active COVID-19 Infection

Alajlan¹,

AlZamil²,

Aseri³

2021

Cureus

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Alopecia areata is a chronic autoimmune disorder attacking the hair follicle epithelium; hence, causing nonscarring hair loss. It has been found that Janus kinase 3 (JAK3) hyperactivity plays a key role in the pathogenesis of the disease. Tofacitinib is an effective JAK1 and JAK3 inhibitor that can block several cytokines such as IL-2, IL-7, and IL-6. Several studies have demonstrated the efficacy of oral tofacitinib in hair regrowth in alopecia areata patients. With the recent COVID-19 pandemic, it has been advised to withhold JAK inhibitors during the period of active infection due to possible immunosuppression. We herein report two cases of patients with alopecia universalis who continued to use tofacitinib during their active COVID-19 infection and showed no deterioration in their course of illness.

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“…Some authors have also reported an increased risk of severe disease among patients with ulcerative colitis (UC) 60,70,74 and in those receiving aminosalicylates, 66 but these observations need further validation in population‐based studies. No further concerns have been reported with the remaining drugs, including small molecules like tofacitinib and biologics like ustekinumab and vedolizumab 73,75–77 …”

Section: Covid‐19 In Ibdmentioning

confidence: 99%

“…No further concerns have been reported with the remaining drugs, including small molecules like tofacitinib and biologics like ustekinumab and vedolizumab . 73 , 75 , 76 , 77 …”

Section: Covid‐19 In Ibdmentioning

confidence: 99%

COVID‐19 in gastroenterology: Where are we now? Current evidence on the impact of COVID‐19 in gastroenterology

et al. 2021

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Background The COVID‐19 pandemic has created unprecedented challenges in all fields of society with social, economic, and health‐related consequences worldwide. In this context, gastroenterology patients and healthcare systems and professionals have seen their routines changed and were forced to adapt, adopting measures to minimize the risk of infection while guaranteeing continuous medical care to chronic patients. Objective At this point, it is important to evaluate the impact of the pandemic on this field to further improve the quality of the services provided in this context. Methods/Results/Conclusion We performed a literature review that summarizes the main aspects to consider in gastroenterology, during the pandemic crisis, and includes a deep discussion on the main changes affecting gastroenterology patients and healthcare systems, anticipating the pandemic recovery scenario with future practices and policies.

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Characteristics and Outcomes of IBD Patients with COVID-19 on Tofacitinib Therapy in the SECURE-IBD Registry

Cited by 51 publications

References 8 publications

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

Tofacitinib Treatment in Patients With Active COVID-19 Infection

COVID‐19 in gastroenterology: Where are we now? Current evidence on the impact of COVID‐19 in gastroenterology

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