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托法替布治疗溃疡性结肠炎的前瞻性观察研究——诱导期临床数据、疲劳及健康相关生活质量分析

Prospective observational study of tofacitinib in ulcerative colitis - analysis of clinical data, fatigue and health-related quality of life during the induction phase.

作者信息

Nyberg Lisa, Halfvarson Jonas, Söderling Jonas, Olén Ola, Strid Hans, Hedin Charlotte R H, Jónsdóttir Sara B, Hjortswang Henrik, Jäghult Susanna, Cappelleri Joseph C, Henrohn Dan, Seddighzadeh Maria, Marsal Jan, Grip Olof

机构信息

Department of Gastroenterology, Skåne University Hospital, Jan Waldenströms gata 16, 205 02 Malmö, Sweden.

Department of Clinical Sciences, Lund University, Lund, Sweden.

出版信息

Therap Adv Gastroenterol. 2025 Jun 16;18:17562848251343427. doi: 10.1177/17562848251343427. eCollection 2025.

Abstract

BACKGROUND

Tofacitinib is a Janus kinase inhibitor for the treatment of ulcerative colitis (UC). Prospective real-world data are scarce.

OBJECTIVES

To collect data on clinical outcomes, including health-related quality of life (HRQoL) and fatigue during treatment with tofacitinib.

DESIGN

This is a prospective observational multicentre study in Sweden. In this analysis, outcomes at weeks 2, 8 and 16 are reported.

METHODS

Patients with active UC confirmed with endoscopy or faecal calprotectin (FC) were enrolled during 2020-2023 when starting tofacitinib therapy.

RESULTS

In total, 103 patients were included. After 2 weeks of treatment, 50% (39/78) had achieved symptomatic response and at week 16, 39% (35/89) had achieved corticosteroid-free clinical remission according to the partial Mayo score. At week 16, a reduction in FC by ⩾50% was seen in 49% (35/71) and 24% (11/46) were in endoscopic remission. The frequency of arthralgia decreased from 29% (30/103) at baseline to 11% (10/89) at week 16. Regarding HRQoL at week 16; each of the four Short Health Scale dimensions (symptoms, social function, disease-related worry and general well-being) had improved by a median of 1 point ( < 0.01) and the European Quality of Life 5 Dimensions 5 Levels index improved from 0.80 to 0.87. Finally, the Inflammatory Bowel Disease Fatigue score measuring occurrence and severity showed an improvement with a decrease from 9 points at baseline to 6 at week 16 ( < 0.05).

CONCLUSION

Induction therapy with tofacitinib therapy was associated with improvements in patient-reported outcome measures of symptoms, endoscopic activity, arthralgia, HRQoL and fatigue. These real-world data illustrate that tofacitinib is a fast-acting drug with broad therapeutic effects in UC.

CLINICALTRIAL REGISTRATION NUMBER

NCT04338204.

摘要

背景

托法替布是一种用于治疗溃疡性结肠炎(UC)的 Janus 激酶抑制剂。前瞻性的真实世界数据稀缺。

目的

收集关于临床结局的数据,包括使用托法替布治疗期间的健康相关生活质量(HRQoL)和疲劳情况。

设计

这是一项在瑞典进行的前瞻性观察性多中心研究。在本分析中,报告了第 2、8 和 16 周时的结局。

方法

2020 年至 2023 年期间,对经内镜检查或粪便钙卫蛋白(FC)确诊为活动性 UC 且开始使用托法替布治疗的患者进行入组。

结果

总共纳入了 103 例患者。治疗 2 周后,50%(39/78)的患者出现症状缓解,在第 16 周时,根据部分 Mayo 评分,39%(35/89)的患者实现了无皮质类固醇临床缓解。在第 16 周时,49%(35/71)的患者 FC 降低≥50%,24%(11/46)的患者达到内镜缓解。关节痛的发生率从基线时的 29%(30/103)降至第 16 周时的 11%(10/89)。关于第 16 周时的 HRQoL;简短健康量表的四个维度(症状、社会功能、疾病相关担忧和总体幸福感)中的每一个维度的中位数均提高了 1 分(P<0.01),欧洲生活质量五维度五级指数从 0.80 提高到 0.87。最后,测量发生情况和严重程度的炎症性肠病疲劳评分有所改善,从基线时的 9 分降至第 16 周时的 6 分(P<0.05)。

结论

托法替布诱导治疗与患者报告的症状、内镜活动、关节痛、HRQoL 和疲劳等结局指标的改善相关。这些真实世界数据表明托法替布是一种起效快且对 UC 具有广泛治疗效果的药物。

临床试验注册号

NCT04338204。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7295/12174757/7b769b7d99f8/10.1177_17562848251343427-img2.jpg

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