Yagi Soichi, Fukui Hirokazu, Ikenouchi Maiko, Shiraishi Tetsuya, Kaku Koji, Wakita Midori, Takagi Yasuhiro, Sato Toshiyuki, Kawai Mikio, Kamikozuru Koji, Yokoyama Yoko, Takagawa Tetsuya, Tomita Toshihiko, Shinzaki Shinichiro
Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya 663-8501, Hyogo, Japan.
Center for Clinical Research and Education, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan.
J Clin Med. 2025 Jan 2;14(1):217. doi: 10.3390/jcm14010217.
Few studies have compared the efficacy and safety of Janus kinase (JAK) inhibitors in patients with ulcerative colitis (UC). We compared the real-world effectiveness and safety of tofacitinib (TOF) and filgotinib (FIL) as induction therapy for UC by propensity score-matching analysis. We enrolled 230 patients with active UC who received either TOF (n = 197) or FIL (n = 33) as induction therapy. The primary outcome was the clinical response at week 8, and the secondary outcomes were the clinical response/remission rates from weeks 2-8, including the course of patients without a clinical response/remission at week 4. Propensity score-matching analysis revealed that the clinical response rate gradually increased to 72.2% at 8 weeks in the TOF group, whereas it tended to decrease to 48.5% in the FIL group. Clinical remission rates increased from 2 (36.7% vs. 36.7%) to 8 weeks (63.6% vs. 48.5%) after treatment in the TOF and FIL groups, respectively. The clinical response rate was higher in the TOF group than in the FIL group at week 8 in patients without a clinical response at week 4 (38.5% vs. 0%; = 0.011). The clinical remission rate was also higher in the TOF group than in the FIL group at week 8 in patients without clinical remission at week 4 (50.0% vs. 16.7%; = 0.046). The incident rates of infection and anemia were higher in the TOF group than in the FIL group. TOF may be more effective than FIL at 8 weeks for patients with UC who do not respond to treatment within the first 4 weeks.
很少有研究比较过Janus激酶（JAK）抑制剂在溃疡性结肠炎（UC）患者中的疗效和安全性。我们通过倾向评分匹配分析比较了托法替布（TOF）和非戈替尼（FIL）作为UC诱导治疗的真实世界有效性和安全性。我们纳入了230例接受TOF（n = 197）或FIL（n = 33）作为诱导治疗的活动性UC患者。主要结局是第8周的临床缓解，次要结局是第2 - 8周的临床缓解率，包括第4周无临床缓解的患者病程。倾向评分匹配分析显示，TOF组在第8周时临床缓解率逐渐升至72.2%，而FIL组则降至48.5%。TOF组和FIL组治疗后临床缓解率分别从2周时的2例（36.7%对36.7%）升至8周时的（63.6%对48.5%）。在第4周无临床缓解的患者中，TOF组在第8周时的临床缓解率高于FIL组（50.0%对16.7%；P = 0.046）。TOF组的感染和贫血发生率高于FIL组。对于在最初4周内对治疗无反应的UC患者，TOF在第8周时可能比FIL更有效。
