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Chaparro M, Garre A, Mesonero F, Rodríguez C, Barreiro-de Acosta M, Martínez-Cadilla J, Arroyo MT, Manceñido N, Sierra-Ausín M, Vera-Mendoza I, Casanova MJ, Nos P, González-Muñoza C, Martínez T, Boscá-Watts M, Calafat M, Busquets D, Girona E, Llaó J, Martín-Arranz MD, Piqueras M, Ramos L, Surís G, Bermejo F, Carbajo AY, Casas-Deza D, Fernández-Clotet A, García MJ, Ginard D, Gutiérrez-Casbas A, Hernández L, Lucendo AJ, Márquez L, Merino-Ochoa O, Rancel FJ, Taxonera C, López Sanromán A, Rubio S, Domènech E, Gisbert JP. Tofacitinib in Ulcerative Colitis: Real-world Evidence From the ENEIDA Registry. J Crohns Colitis 2021; 15:35-42. [PMID: 32969471 DOI: 10.1093/ecco-jcc/jjaa145] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM To evaluate the effectiveness and safety of tofacitinib in ulcerative colitis [UC] in real life. METHODS Patients from the prospectively maintained ENEIDA registry and treated with tofacitinib due to active UC were included. Clinical activity and effectiveness were defined based on Partial Mayo Score [PMS]. Short-term response/remission was assessed at Weeks 4, 8, and 16. RESULTS A total of 113 patients were included. They were exposed to tofacitinib for a median time of 44 weeks. Response and remission at Week 8 were 60% and 31%, respectively. In multivariate analysis, higher PMS at Week 4 (odds ratio [OR] = 0].2; 95% confidence interval [CI] = 0].1-0.4) was the only variable associated with lower likelihood of achieving remission at Week 8. Higher PMS at Week 4 [OR = 0.5; 95% CI = 0.3-0.7] and higher PMS at Week 8 [OR = 0.2; 95% CI = 0.1-0.5] were associated with lower probability of achieving remission at Week 16. A total of 45 patients [40%] discontinued tofacitinib over time. Higher PMS at Week 8 was the only factor associated with higher tofacitinib discontinuation [hazard ratio = 1.5; 95% CI = 1.3-1.6]. A total of 34 patients had remission at Week 8; of these, 65% had relapsed 52 weeks after achieving remission; the dose was increased to 10 mg/12 h in nine patients, and five of them reached remission again. Seventeen patients had adverse events. CONCLUSIONS Tofacitinib is effective and safe in UC patients in real practice, even in a highly refractory cohort. A relevant proportion of patients discontinue the drug over time, mainly due to primary failure.
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Affiliation(s)
- María Chaparro
- Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Ana Garre
- Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Francisco Mesonero
- Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Cristina Rodríguez
- Gastroenterology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Manuel Barreiro-de Acosta
- Gastroenterology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Jesús Martínez-Cadilla
- Gastroenterology Department, Hospital Álvaro Cunqueiro-Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - María T Arroyo
- Gastroenterology Department, Hospital Clínico Universitario Lozano Blesa and CIBERehd, IIS Aragón, Zaragoza, Spain
| | - Noemí Manceñido
- Gastroenterology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain
| | - Mónica Sierra-Ausín
- Gastroenterology Department, Complejo Asistencial Universitario de León, León Spain
| | - Isabel Vera-Mendoza
- Gastroenterology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - María José Casanova
- Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Pilar Nos
- Gastroenterology Department, Hospital Universitario y Politécnico La Fe and CIBERehd, Valencia, Spain
| | - Carlos González-Muñoza
- Gastroenterology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain
| | - Teresa Martínez
- Gastroenterology Department, Hospital Virgen de la Luz, Cuenca, Spain
| | - Maia Boscá-Watts
- Gastroenterology Department, Hospital Clinico de Valencia and Universitat de Valencia, Valencia, Spain
| | - Margalida Calafat
- Gastroenterology Department, Hospital Universitari Germans Trials i Pujol and CIBERehd, Badalona, Barcelona, Spain
| | - David Busquets
- Gastroenterology Department, Hospital Universitario de Gerona Dr Josep Trueta, Girona, Spain
| | - Eva Girona
- Gastroenterology Department, Hospital General Universitario de Elche, Alicante, Spain
| | - Jordina Llaó
- Gastroenterology Department, Hospital Sant Joan de Déu, Althaia, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | - María Dolores Martín-Arranz
- Department of Gastroenterology, and Innate Immunity Group, IdiPAZ Institute for Health Research, La Paz Hospital, Madrid, Spain
| | - Marta Piqueras
- Gastroenterology Department, Consorci Sanitari de Terrasa, Barcelona, Spain
| | - Laura Ramos
- Gastroenterology Department, Hospital Universitario de Canarias, Islas Canarias, Spain
| | - Gerard Surís
- Gastroenterology Department, Hospital de Bellvitge and IDIBELL, L'Hospitalet, Spain
| | - Fernando Bermejo
- Gastroenterology Department, Hospital Universitario de Fuenlabrada, Instituto de Investigación Sanitaria del Hospital La Paz [IdiPaz], Madrid, Spain
| | - Ana Y Carbajo
- Gastroenterology Department, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Diego Casas-Deza
- Gastroenterology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - María J García
- Gastroenterology Department, Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain
| | - Daniel Ginard
- Gastroenterology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Ana Gutiérrez-Casbas
- Gastroenterology Department, Hospital General Universitario de Alicante and CIBERehd, Alicante, Spain
| | - Luis Hernández
- Gastroenterology Department, Hospital Santos Reyes de Aranda del Duero, Burgos, Spain
| | - Alfredo J Lucendo
- Gastroenterology Department, Hospital General de Tomelloso, IIS-IP and CIBEREHD Ciudad Real, Spain
| | - Lucía Márquez
- Gastroenterology Department, Hospital del Mar and Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Olga Merino-Ochoa
- Gastroenterology Department, Hospital Universitario de Cruces, Vizcaya, Spain
| | - Francisco J Rancel
- Gastroenterology Department, Complejo Hospitalario de Palencia, Palencia, Spain
| | - Carlos Taxonera
- Gastroenterology Department, Hospital Clínico San Carlos and IdISSC, Madrid, Spain
| | | | - Saioa Rubio
- Gastroenterology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Eugeni Domènech
- Gastroenterology Department, Hospital Universitari Germans Trials i Pujol and CIBERehd, Badalona, Barcelona, Spain
| | - Javier P Gisbert
- Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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