Histological healing induced by tofacitinib in ulcerative colitis: A multicentre study.

Histologic remission Neutrophilic infiltrate Tofacitinib Ulcerative colitis

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
07 Dec 2023
Historique:
received: 13 09 2023
revised: 18 11 2023
accepted: 20 11 2023
medline: 9 12 2023
pubmed: 9 12 2023
entrez: 8 12 2023
Statut: aheadofprint

Résumé

While the efficacy of tofacitinib to induce and maintain clinical and endoscopic remission is well established in ulcerative colitis (UC), little is known about its efficacy to induce histological remission. We conducted a retrospective multicentric cohort study. UC patients ≥ 16 years treated by tofacitinib in whom histological activity has been evaluated before and after induction were eligible. The primary endpoint was the histological remission at the end of induction, assessed by the Nancy index and the epithelial neutrophilic infiltrate. A total of 42 patients with UC (93% previously exposed to an anti-TNF and 81% to vedolizumab) were included between July 2018 and April 2022 and were followed for a median duration of 84 weeks [IQR, 35-134]. At the end of induction period (whether prolonged or not), 19% and 24% of patients achieved histological remission, using the Nancy index and the epithelial neutrophilic infiltrate, respectively. Survival without tofacitinib discontinuation was significantly longer in patients without epithelial neutrophilic infiltrate at the end of induction (whether prolonged or not) compared with patients with epithelial neutrophilic infiltrate (p = 0.036). Tofacitinib induced histological remission in one fifth to one quarter of patients with UC who have previously failed anti-TNF or/and vedolizumab after induction (whether prolonged or not).

Sections du résumé

BACKGROUND BACKGROUND
While the efficacy of tofacitinib to induce and maintain clinical and endoscopic remission is well established in ulcerative colitis (UC), little is known about its efficacy to induce histological remission.
METHODS METHODS
We conducted a retrospective multicentric cohort study. UC patients ≥ 16 years treated by tofacitinib in whom histological activity has been evaluated before and after induction were eligible. The primary endpoint was the histological remission at the end of induction, assessed by the Nancy index and the epithelial neutrophilic infiltrate.
RESULTS RESULTS
A total of 42 patients with UC (93% previously exposed to an anti-TNF and 81% to vedolizumab) were included between July 2018 and April 2022 and were followed for a median duration of 84 weeks [IQR, 35-134]. At the end of induction period (whether prolonged or not), 19% and 24% of patients achieved histological remission, using the Nancy index and the epithelial neutrophilic infiltrate, respectively. Survival without tofacitinib discontinuation was significantly longer in patients without epithelial neutrophilic infiltrate at the end of induction (whether prolonged or not) compared with patients with epithelial neutrophilic infiltrate (p = 0.036).
CONCLUSION CONCLUSIONS
Tofacitinib induced histological remission in one fifth to one quarter of patients with UC who have previously failed anti-TNF or/and vedolizumab after induction (whether prolonged or not).

Identifiants

pubmed: 38065698
pii: S1590-8658(23)01040-X
doi: 10.1016/j.dld.2023.11.022
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interests S Vieujean lecture and/or consulting fees from Abbvie, Ferring, Janssen, Takeda. D Laharie counselling, boards, transports and/or fees from Abbvie, Biogaran, Biogen, Ferring, HAC-pharma, Janssen, MSD, Novartis, Pfizer, Prometheus, Roche, Takeda, Theradiag, Tillots. A Buisson received consulting fees from AbbVie, Amgen, Arena, Biogen, Celltrion Healthcare, CTMA, Galapagos, Janssen, MSD, Nexbiome, Pfizer, Roche, Takeda, and Tillotts; and lecture fees from AbbVie, Amgen, Biogen, Galapagos, Janssen, Mayoli-Spindler, MSD, Norgine, Pfizer, Roche, Takeda, Tillotts, and Vifor Pharma. X Roblin served as a speaker, a consultant, and/or an advisory board member for MSD, Pfizer, Celltrion, Janssen, Takeda, AbbVie, Amgen, Biogen, Galapagos, Roche, and Theradiag. M Fumery declares financial support from Abbvie, MSD, Ferring, Boehringer, Pfizer, Takeda, Biogen, Amgen, Gilead, Sandoz, Celgene, Galapagos, Janssen, and Tillots Pharma. S Nancey declares lecture and/or consulting fees from Abbvie, Janssen, Ferring, Takeda, Amgen, Biogen, Novartis, Celltrion, Pfizer, MEDAC, NORDIC Pharma, Maat Pharma. P Wils declares lecture and/or consulting fees from Abbvie, Ferring, Biogen, Janssen, Celltrion, Takeda. R Altwegg declares counselling, boards, transports or fees from Abbvie, Amgen, Biogen, Ferring, Janssen, MSD, Pfizer, Takeda, Tillotts. L Seidel has no conflict of interest. B Caron declares lecture and/or consulting fees from Abbvie, Amgen, Celltrion, Ferring, Janssen, Lilly, and Takeda. L Peyrin-Biroulet declares consulting fees from AbbVie, Adacyte, Alimentiv, Alma Bio Therapeutics, Amgen, Applied Molecular Transport, Arena, Biogen, BMS, Celltrion, CONNECT Biopharm, Cytoki Pharma, Enthera, Ferring, Fresenius Kabi, Galapagos, Genentech, Gilead, Gossamer Bio, GSK, HAC-Pharma, IAG Image Analysis, Index Pharmaceuticals, Inotrem, Janssen, Lilly, Medac, Mopac, Morphic, MSD, Norgine, Nordic Pharma, Novartis, OM Pharma, ONO Pharma, OSE Immunotherapeutics, Pandion Therapeutics, Par'Immune, Pfizer, Prometheus, Protagonist, Roche, Sanofi, Sandoz, Takeda, Theravance, Thermo Fisher, Tigenix, Tillots, Viatris, Vifor, Ysopia, Abivax, Samsung, Ventyx, Roivant, Vectivbio.

Auteurs

Sophie Vieujean (S)

Hepato-Gastroenterology and Digestive Oncology, University Hospital CHU of Liège, Liège, Belgium.

David Laharie (D)

CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology department, Université de Bordeaux, INSERM CIC 1401, Bordeaux, France.

Anthony Buisson (A)

Université Clermont Auvergne, Inserm, CHU Clermont-Ferrand, 3iHP, Service d'Hépato-Gastro Entérologie, Clermont-Ferrand, France.

Xavier Roblin (X)

Department of Gastroenterology, University Hospital of Saint-Etienne, Saint-Etienne, France.

Mathurin Fumery (M)

Gastroenterology Unit, Amiens University Hospital and PeriTox, Université de Picardie Jules Verne, Amiens UMR-IO1, France.

Stephane Nancey (S)

Gastroenterology Department CHU Lyon-Sud, Hospices Civils de Lyon, University Claude Bernard Lyon 1, INSERM U1111 - CIRI, Lyon, France.

Pauline Wils (P)

Univ. Lille, Inserm, CHU Lille, U1286 - Institute for Translational Research in Inflammation, Lille F-59000, France.

Romain Altwegg (R)

Hepato-gastroenterology Department, CHU Montpellier, Montpellier, France.

Laurence Seidel (L)

Biostatistics and medico-economic information department, Liège, Belgium.

Bénédicte Caron (B)

Department of Gastroenterology, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France; INSERM, NGERE, University of Lorraine, Nancy F-54000, France; NFINY Institute, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France; FHU-CURE, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France.

Laurent Peyrin-Biroulet (L)

Department of Gastroenterology, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France; INSERM, NGERE, University of Lorraine, Nancy F-54000, France; NFINY Institute, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France; FHU-CURE, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France; Groupe Hospitalier privé Ambroise Paré - Hartmann, Paris IBD centre, Neuilly sur Seine 92200, France; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC, Canada. Electronic address: peyrinbiroulet@gmail.com.

Classifications MeSH