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溃疡性结肠炎中托法替尼的真实世界证据:短期和长期疗效及安全性。

Real-World Evidence of Tofacinitib in Ulcerative Colitis: Short-Term and Long-Term Effectiveness and Safety.

机构信息

Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.

Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.

出版信息

Am J Gastroenterol. 2023 Jul 1;118(7):1237-1247. doi: 10.14309/ajg.0000000000002145. Epub 2022 Dec 14.

Abstract

INTRODUCTION

The objective of this study was to assess the durability, short-term and long-term effectiveness, and safety of tofacitinib in ulcerative colitis (UC) in clinical practice.

METHODS

This is a retrospective multicenter study including patients with UC who had received the first tofacitinib dose at least 8 weeks before the inclusion. Clinical effectiveness was based on partial Mayo score.

RESULTS

A total of 408 patients were included. Of them, 184 (45%) withdrew tofacitinib during follow-up (mean = 18 months). The probability of maintaining tofacitinib was 67% at 6 m, 58% at 12 m, and 49% at 24 m. The main reason for tofacitinib withdrawal was primary nonresponse (44%). Older age at the start of tofacitinib and a higher severity of clinical activity were associated with tofacitinib withdrawal. The proportion of patients in remission was 38% at week 4, 45% at week 8, and 47% at week 16. Having moderate-to-severe vs mild disease activity at baseline and older age at tofacitinib start were associated with a lower and higher likelihood of remission at week 8, respectively. Of 171 patients in remission at week 8, 83 (49%) relapsed. The probability of maintaining response was 66% at 6 m and 54% at 12 m. There were 93 adverse events related to tofacitinib treatment (including 2 pulmonary thromboembolisms [in patients with risk factors] and 2 peripheral vascular thrombosis), and 29 led to tofacitinib discontinuation.

DISCUSSION

Tofacitinib is effective in both short-term and long-term in patients with UC. The safety profile is similar to that previously reported.

摘要

简介

本研究旨在评估托法替布在溃疡性结肠炎(UC)临床实践中的耐久性、短期和长期疗效及安全性。

方法

这是一项回顾性多中心研究,纳入了至少在纳入前 8 周接受首剂托法替布治疗的 UC 患者。临床疗效基于部分 Mayo 评分。

结果

共纳入 408 例患者。其中,184 例(45%)在随访期间停用托法替布(平均 18 个月)。托法替布维持率分别为 6 个月时 67%、12 个月时 58%、24 个月时 49%。托法替布停药的主要原因是原发无应答(44%)。托法替布起始时年龄较大和临床活动度较高与托法替布停药相关。第 4 周时缓解率为 38%,第 8 周时为 45%,第 16 周时为 47%。基线时疾病活动度为中重度与轻度相比、托法替布起始时年龄较大与缓解率较低相关。第 8 周时缓解的 171 例患者中,83 例(49%)复发。第 6 个月时维持缓解的概率为 66%,第 12 个月时为 54%。与托法替布治疗相关的不良事件共 93 例(包括 2 例有危险因素的肺血栓栓塞和 2 例周围血管血栓形成),29 例导致托法替布停药。

讨论

托法替布治疗 UC 短期和长期均有效。安全性与先前报道的相似。

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