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Real-World Experience with Tofacitinib in IBD at a Tertiary Center

  • Roni Weisshof
  • Maya Aharoni Golan
  • Philip H. Sossenheimer
  • Katia El Jurdi
  • Jacob E. Ollech
  • Joel Pekow
  • Russel D. Cohen
  • Atsushi Sakuraba
  • Sushila Dalal
  • David T. RubinEmail author
Original Article
  • 51 Downloads

Abstract

Background and Aims

Many inflammatory bowel disease (IBD) patients do not respond to medical therapy. Tofacitinib is a first-in-class, partially selective inhibitor of Janus kinase, recently approved for treating patients with ulcerative colitis (UC). We describe our experience with the use of tofacitinib for treatment of patients with moderate-to-severe IBD.

Methods

This is a retrospective, observational study of the use of tofacitinib in IBD. Patients with medically resistant IBD were treated orally with 5 mg or 10 mg twice daily. Clinical response and adverse events were assessed at 8, 26, and 52 weeks. Objective response was assessed endoscopically, radiologically, and biochemically.

Results

58 patients (53 UC, 4 Crohn’s, 1 pouchitis) completed at least 8 weeks of treatment with tofacitinib. 93% of the patients previously failed treatment with anti-TNF. At 8 weeks of treatment, 21 patients (36%) achieved a clinical response, and 19 (33%) achieved clinical remission. Steroid-free remission at 8 weeks was achieved in 15 patients (26%). Of the 48 patients followed for 26 weeks, 21% had clinical, steroid-free remission. Of the 26 patients followed for 12 months, 27% were in clinical, steroid-free remission. Twelve episodes of systemic infections were noted, mostly while on concomitant steroids. One episode of herpes zoster infection was noted during follow-up.

Conclusions

In this cohort of patients with moderate-to-severe, anti-TNF resistant IBD, tofacitinib induced clinical response in 69% of the patients. 27% were in clinical, steroid-free remission by 1 year of treatment. Tofacitinib is an effective therapeutic option for this challenging patient population.

Keywords

Ulcerative colitis Inflammatory bowel disease Tofacitinib Jak inhibitors 

Notes

Compliance with ethical standards

Conflict of interest

RW, MAG, KEJ, and PHS have no relevant disclosures. DTR is a consultant and has received grant support from Abbvie, Abgenomics, Allergan Inc, Ferring Pharmaceuticals, Genentech/Roche, Janssen Pharmaceuticals, Merck & Co Inc., Medtronic, Napo Pharmaceuticals, Takeda, Pfizer, Shire and Target Pharmaceuticals.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Roni Weisshof
    • 1
  • Maya Aharoni Golan
    • 1
  • Philip H. Sossenheimer
    • 1
  • Katia El Jurdi
    • 1
  • Jacob E. Ollech
    • 1
  • Joel Pekow
    • 1
  • Russel D. Cohen
    • 1
  • Atsushi Sakuraba
    • 1
  • Sushila Dalal
    • 1
  • David T. Rubin
    • 1
    Email author
  1. 1.Inflammatory Bowel Disease CenterUniversity of Chicago MedicineChicagoUSA

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