Endo-histologic Normalization Is Achievable with Tofacitinib and Is Associated with Improved Clinical Outcomes

Cohen, Nathaniel A.; Steinberg, Joshua M.; Silfen, Alexa; Rodriguez, Tina G.; Singer, Jorie; Patel, Shivani A.; Cohen, Russell D.; Dalal, Sushila; Sakuraba, Atsushi; Pekow, Joel; Micic, Dejan; Rubin, David T.

doi:10.1007/s10620-022-07716-0

Cited by 7 publications

(1 citation statement)

References 31 publications

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“… 44 described that five out of five PSC patients experienced some improvement, while Cohen et al . 61 reported that one out of two patients had impairment in their results [ Supplementary Figures S16 and S17 ].…”

Section: Resultsmentioning

confidence: 99%

Beyond the Gut: A Systematic Review and Meta-analysis of Advanced Therapies for Inflammatory Bowel Disease-associated Extraintestinal Manifestations

Tímár,

Párniczky,

Budai

et al. 2024

Journal of Crohn's and Colitis

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Background and Aims Extraintestinal manifestations are frequent in patients with inflammatory bowel disease and have a negative impact on quality of life. Currently, however, there is no evidence available to determine which drug should be recommended for these patients beyond anti-TNF treatment. We aimed to analyse the frequency of new extraintestinal manifestations and the behaviour of pre-existing extraintestinal manifestations during advanced therapy. Methods We conducted a systematic search on November 15th, 2022, and enrolled randomised controlled trials, cohorts and case series reporting the occurrence and behaviour of extraintestinal manifestations in patients with inflammatory bowel disease receiving advanced therapy (non-TNF inhibitor biologicals and JAK inhibitors). Proportions of new, recurring, worsening, and improving extraintestinal manifestations were calculated with 95% confidence intervals (CIs). The risk of bias was assessed with QUIPS tool. Results Altogether, 61 studies comprising 13,806 patients reported eligible data on extraintestinal manifestations. The overall proportion of new extraintestinal manifestations was 8% (95%CI, 6% to 12%) during advanced therapy. There was no significant difference between the frequency of new extraintestinal manifestations during vedolizumab and ustekinumab therapy (11%, 95%CI, 8% to 15% versus 6%, 95%CI, 3% to 11%, p=0.166). The improvement of pre-existing manifestations was comparable between vedolizumab and ustekinumab-treated patients, except for joint involvement (42%, 95%CI, 32% to53% versus 54%, 95%CI, 42% to65%, p=0.029). Conclusion The proportion of new extraintestinal manifestations was low during advanced therapy. Furthermore, the improvement of pre-existing manifestations was comparable between advanced therapies, except for pre-existing joint manifestations.

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Section: Resultsmentioning

confidence: 99%

Beyond the Gut: A Systematic Review and Meta-analysis of Advanced Therapies for Inflammatory Bowel Disease-associated Extraintestinal Manifestations

Tímár,

Párniczky,

Budai

et al. 2024

Journal of Crohn's and Colitis

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Effects of immunosuppressive treatment on patient outcomes after immune checkpoint inhibitor-related gastrointestinal toxicity

Shatila

Cui

et al. 2023

J Cancer Res Clin Oncol

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Experience with Tofacitinib in Patients with Ulcerative Colitis: Data from a United States Claims Database

Chiorean,

Ha,

Hur

et al. 2023

Dig Dis Sci

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Background Tofacitinib is an oral small molecule Janus kinase inhibitor for the treatment of ulcerative colitis (UC). Aims To evaluate real-world data in US patients with UC receiving tofacitinib. Methods Characteristics and outcomes of patients with UC initiating tofacitinib between 2018 and 2019 were assessed using data from the IBM® MarketScan® claims database. The index date was the first tofacitinib claim; pre- and post-index periods were 12 months. Outcomes included tofacitinib adherence/persistence, oral corticosteroid (OCS) use, and healthcare resource utilization (HCRU) and costs. Results Of 276 patients with UC who initiated tofacitinib, 68 (24.6%) were bio-naïve, and 208 (75.4%) bio-experienced. At month 12, overall median tofacitinib adherence (proportion of days covered) was 0.82 (mean 0.68); 43.8% of patients discontinued tofacitinib (90-day gap). Of patients receiving OCS during the post-index 16-week tapering period, 40.4% discontinued OCS up to 12 months post-index. OCS use decreased in patients continuing tofacitinib versus those discontinuing tofacitinib (29.7% vs 59.5%, respectively). Reductions in all-cause and UC-related outpatient visits were observed for bio-naïve (− 1.34 and − 0.88, respectively) and bio-experienced (− 4.72 and − 5.16, respectively) patients, post-index. Decreased UC-related costs per year were observed for bio-experienced patients (difference in post-index vs pre-index, − US$12,448; driven by changes in pharmacy costs), but not for bio-naïve patients (US$47,152). Conclusions In this real-world analysis in a mostly bio-experienced population, the majority of US patients with UC initiating tofacitinib remained on therapy at 12 months, and OCS use was reduced with tofacitinib treatment. HCRU (all patients) and UC-related costs were reduced in bio-experienced patients. Graphical Abstract The majority of patients with ulcerative colitis starting tofacitinib in this real-world study continued therapy at 12 months; there was a reduction in the use of steroids, and a decrease in healthcare resournce utilization and costs. Supplementary Information The online version contains supplementary material available at 10.1007/s10620-023-08063-4.

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Endo-histologic Normalization Is Achievable with Tofacitinib and Is Associated with Improved Clinical Outcomes

Cited by 7 publications

References 31 publications

Beyond the Gut: A Systematic Review and Meta-analysis of Advanced Therapies for Inflammatory Bowel Disease-associated Extraintestinal Manifestations

Beyond the Gut: A Systematic Review and Meta-analysis of Advanced Therapies for Inflammatory Bowel Disease-associated Extraintestinal Manifestations

Effects of immunosuppressive treatment on patient outcomes after immune checkpoint inhibitor-related gastrointestinal toxicity

Experience with Tofacitinib in Patients with Ulcerative Colitis: Data from a United States Claims Database

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