Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan.
Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan.
J Gastroenterol Hepatol. 2022 Oct;37(10):1884-1892. doi: 10.1111/jgh.15923. Epub 2022 Jul 21.
Tofacitinib is an oral small molecule Janus kinase inhibitor for the treatment of ulcerative colitis (UC). We present safety and efficacy data from patients from East Asia (Japan, Korea, and Taiwan) in OCTAVE Open, an open-label, long-term extension study.
Patients in remission at OCTAVE Open baseline received tofacitinib 5 mg twice daily (BID); all others received tofacitinib 10 mg BID. Proportions and IRs (unique patients with events/100 patient-years) were calculated for adverse events (AEs) of special interest. Efficacy endpoints were evaluated up to 36 months.
In OCTAVE Open, 105/944 patients were from East Asia (tofacitinib 5 mg BID, n = 22; tofacitinib 10 mg BID, n = 83). Overall, 87.6% and 24.8% of patients had AEs and serious AEs, respectively; IRs (95% CI) for AEs of special interest were herpes zoster (HZ; non-serious and serious), 6.07 (3.40-10.02); serious infections, 1.47 (0.40-3.76); opportunistic infections, 1.91 (0.62-4.45); major cardiovascular adverse events, 0.37 (0.01-2.04); malignancies (excluding non-melanoma skin cancer [NMSC]), 0.37 (0.01-2.04); and NMSC, 0.00 (0.00-1.35). No deaths, venous thromboembolic events, or gastrointestinal perforations occurred. At month 36, 68.2% and 54.2% of patients had a clinical response, 68.2% and 53.0% had endoscopic improvement, and 63.6% and 49.4% were in remission with tofacitinib 5 and 10 mg BID, respectively.
The HZ IR in East Asian patients was numerically higher versus the global study population; excluding HZ, tofacitinib safety and efficacy were consistent with the global study population.
托法替布是一种用于治疗溃疡性结肠炎(UC)的口服小分子 Janus 激酶抑制剂。我们报告了 OCTAVE Open 中来自东亚(日本、韩国和中国台湾)的患者的安全性和疗效数据,这是一项开放标签、长期扩展研究。
在 OCTAVE Open 基线时处于缓解期的患者接受托法替布 5mg,每日两次(bid);其余患者接受托法替布 10mg bid。计算特殊关注不良事件(AE)的不良事件(AE)的比例和发生率(每 100 患者-年出现事件的独特患者数)。疗效终点评估长达 36 个月。
在 OCTAVE Open 中,944 例患者中有 105 例来自东亚(托法替布 5mg bid,n=22;托法替布 10mg bid,n=83)。总体而言,87.6%和 24.8%的患者分别发生了 AE 和严重 AE;特殊关注 AE 的发生率(95%CI)为带状疱疹(非严重和严重)6.07(3.40-10.02);严重感染 1.47(0.40-3.76);机会性感染 1.91(0.62-4.45);主要心血管不良事件 0.37(0.01-2.04);恶性肿瘤(不包括非黑色素瘤皮肤癌[NMSC])0.37(0.01-2.04);NMSC,0.00(0.00-1.35)。无死亡、静脉血栓栓塞事件或胃肠道穿孔发生。在第 36 个月时,托法替布 5mg 和 10mg bid 的患者分别有 68.2%和 54.2%达到临床缓解,68.2%和 53.0%达到内镜改善,63.6%和 49.4%达到缓解。
东亚患者的带状疱疹发生率高于全球研究人群;不包括带状疱疹,托法替布的安全性和疗效与全球研究人群一致。