Successful initial tofacitinib treatment for acute severe ulcerative colitis with steroid resistance: a case series

 
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Annals of Gastroenterology
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Μελέτη περίπτωσης (EL)
2022 (EL)
Successful initial tofacitinib treatment for acute severe ulcerative colitis with steroid resistance: a case series (EN)
Matsui, Shigenaga
Nishida, Naoshi
Kudo, Masatoshi
Takada, Ryutaro
Honjo, Hajime
Kono, Masashi
Takenaka, Mamoru
Komeda, Yoriaki
Kashida, Hiroshi
Masaki, Sho
Nagai, Tomoyuki
Hagiwara, Satoru
Tribonias, George
Tsuji, Naoko
Background The standard therapy for acute severe ulcerative colitis (ASUC) is intravenous corticosteroids; however, 30% of ulcerative colitis (UC) patients do not recover with corticosteroids alone. Few studies have reported the efficacy and safety of tofacitinib for ASUC with steroid resistance. We report a case series of successful first-line treatment consisting of tofacitinib (20 mg/day) administered to ASUC patients with steroid resistance. Methods Patients diagnosed with ASUC at our institution between October 2018 and February 2020 were retrospectively evaluated. They were administered a high dose of tofacitinib (20 mg) after showing no response to steroid therapy in a dose of 1-1.5 mg/kg/day. Results Eight patients with ASUC, 4 (50%) men, median age 47.1 (range 19-65) years, were included. Four patients were newly diagnosed, and the median UC duration was 4 (range 0-20) years. Six of the 8 patients were able to avoid colectomy. One patient (patient 2) had no response; however, remission was achieved after switching from tofacitinib to infliximab. One patient (patient 6) with no response to tofacitinib underwent total colectomy. Only one patient (patient 4) experienced an adverse event, local herpes zoster, treated with acyclovir without tofacitinib discontinuation. Conclusions Clinical remission without serious adverse events can be achieved with high probability and colectomy can be avoided by first administering high-dose tofacitinib to steroid-resistant ASUC patients. Tofacitinib may be one of the first-line treatment options for steroid-resistant ASUC. Keywords Tofacitinib, JAK inhibitor, acute severe ulcerative colitis, steroid resistance, case series Ann Gastroenterol 2023; 36 (1): 97-102 (EN)
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Αγγλική γλώσσα
2022-12-25
http://www.annalsgastro.gr/index.php/annalsgastro/article/view/6720
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 36, No 1 (2023); 97 (EN)
Copyright (c) 2022 Annals of Gastroenterology (EN)



*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.