Tofacitinib as salvage therapy for 55 ...
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Article dans une revue scientifique: Article original
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Title :
Tofacitinib as salvage therapy for 55 patients hospitalised with refractory severe ulcerative colitis: A GETAID cohort.
Author(s) :
Uzzan, Mathieu [Auteur]
Hôpital Beaujon [AP-HP]
Centre de recherche sur l'Inflammation [CRI (UMR_S_1149 / ERL_8252 / U1149)]
Bresteau, C. [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Laharie, D. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Stefanescu, C. [Auteur]
Bellanger, C. [Auteur]
Carbonnel, F. [Auteur]
Serrero, M. [Auteur]
CHU Marseille
Viennot, S. [Auteur]
CHU Caen
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Amiot, A. [Auteur]
CHI Créteil
Altwegg, R. [Auteur]
CHU Montpellier = Montpellier University Hospital
Picon, L. [Auteur]
Nahon, S. [Auteur]
Groupe Hospitalier Intercommunal Le Raincy-Montfermeil
Vuitton, L. [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Ah Soune, P. [Auteur]
Kirchgesner, J. [Auteur]
Institut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP]
CHU Saint-Antoine [AP-HP]
Peyrin-Biroulet, L. [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]
Bouhnik, Y. [Auteur]
Hôpital Beaujon [AP-HP]
Hôpital Beaujon [AP-HP]
Centre de recherche sur l'Inflammation [CRI (UMR_S_1149 / ERL_8252 / U1149)]
Bresteau, C. [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Laharie, D. [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Stefanescu, C. [Auteur]
Bellanger, C. [Auteur]
Carbonnel, F. [Auteur]
Serrero, M. [Auteur]
CHU Marseille
Viennot, S. [Auteur]
CHU Caen
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Amiot, A. [Auteur]
CHI Créteil
Altwegg, R. [Auteur]
CHU Montpellier = Montpellier University Hospital
Picon, L. [Auteur]
Nahon, S. [Auteur]
Groupe Hospitalier Intercommunal Le Raincy-Montfermeil
Vuitton, L. [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Ah Soune, P. [Auteur]
Kirchgesner, J. [Auteur]
Institut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP]
CHU Saint-Antoine [AP-HP]
Peyrin-Biroulet, L. [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]
Bouhnik, Y. [Auteur]
Hôpital Beaujon [AP-HP]
Journal title :
Alimentary Pharmacology and Therapeutics
Abbreviated title :
Aliment Pharmacol Ther
Publication date :
2021-06-28
ISSN :
1365-2036
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
Up to 25% of patients with ulcerative colitis (UC) will require hospitalization for severe flare. In patients hospitalised for severe flare, who previously experienced multiple drug failures, including steroids ...
Show more >Background Up to 25% of patients with ulcerative colitis (UC) will require hospitalization for severe flare. In patients hospitalised for severe flare, who previously experienced multiple drug failures, including steroids and anti-TNF agents, new quick-acting medical options are needed. Tofacitinib is effective in refractory UC and has a rapid onset of action. Aim To evaluate effectiveness and safety of tofacitinib as rescue therapy in patients hospitalised for UC flare. Methods We conducted an observational and multicentre study with both retrospective and prospective collections in 14 GETAID centres. The primary objective was to assess the survival without colectomy following tofacitinib initiation in patients hospitalised for a UC flare. We determined rates of clinical response, clinical remission, and steroid-free clinical remission at week 6 and week 14 and safety. Results Fifty-five patients were included (49 with prior infliximab failure and 19 previously exposed to ciclosporin). With a median follow-up of 6.5 months (interquartile range [IQR] [3-12.3]), rate of colectomy-free survival was estimated at 78.9% (95 CI [68.5-90.9]) and 73.6% (95 CI [61.9-87.3]) at 3 and 6 months, respectively. Rates of clinical response, clinical remission and steroid-free clinical remission were 60%, 45.5% and 37.5% at week 6 and 41.8%, 34.5% and 32.7% at week 14. Regarding safety, no death was observed, three patients withdrew tofacitinib due to adverse events. Two herpes zoster infections occurred in patients aged over 60 years old. No venous thrombotic or major adverse cardiovascular events occurred. Conclusion Tofacitinib appears as a promising option in patients hospitalised with a UC flare but needs further validation in controlled trials.Show less >
Show more >Background Up to 25% of patients with ulcerative colitis (UC) will require hospitalization for severe flare. In patients hospitalised for severe flare, who previously experienced multiple drug failures, including steroids and anti-TNF agents, new quick-acting medical options are needed. Tofacitinib is effective in refractory UC and has a rapid onset of action. Aim To evaluate effectiveness and safety of tofacitinib as rescue therapy in patients hospitalised for UC flare. Methods We conducted an observational and multicentre study with both retrospective and prospective collections in 14 GETAID centres. The primary objective was to assess the survival without colectomy following tofacitinib initiation in patients hospitalised for a UC flare. We determined rates of clinical response, clinical remission, and steroid-free clinical remission at week 6 and week 14 and safety. Results Fifty-five patients were included (49 with prior infliximab failure and 19 previously exposed to ciclosporin). With a median follow-up of 6.5 months (interquartile range [IQR] [3-12.3]), rate of colectomy-free survival was estimated at 78.9% (95 CI [68.5-90.9]) and 73.6% (95 CI [61.9-87.3]) at 3 and 6 months, respectively. Rates of clinical response, clinical remission and steroid-free clinical remission were 60%, 45.5% and 37.5% at week 6 and 41.8%, 34.5% and 32.7% at week 14. Regarding safety, no death was observed, three patients withdrew tofacitinib due to adverse events. Two herpes zoster infections occurred in patients aged over 60 years old. No venous thrombotic or major adverse cardiovascular events occurred. Conclusion Tofacitinib appears as a promising option in patients hospitalised with a UC flare but needs further validation in controlled trials.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Submission date :
2024-01-12T06:39:13Z
2024-03-01T12:56:53Z
2024-03-01T12:56:53Z