DOP75 Effectiveness and Safety of tofacitinib versus vedolizumab in Patients with Ulcerative Colitis; A Nationwide, ICC Registry study
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Le résumé fourni par la source
Abstract Background Clinicians face difficulty in positioning biologics and JAK inhibitors in anti-TNF refractory ulcerative colitis (UC) patients. Head-to-head trials comparing the efficacy of vedolizumab and tofacitinib in UC patients are lacking. We aimed to compare the effectiveness and safety of vedolizumab and tofacitinib in anti-TNF experienced UC patients in our prospective, nationwide registry using a propensity score weighted cohort. Methods UC patients who failed anti-TNF treatment (with or without thiopurine) and initiated vedolizumab or tofacitinib treatment subsequently, were identified in the observational prospective Initiative on Crohn and Colitis (ICC) Registry. We selected patients with both clinical (Simple Clinical Colitis Activity Index (SCCAI) >2) and biochemical (C-reactive protein (CRP) >5mg/L or faecal calprotectin (FC) >250 µg/g) or endoscopic disease activity (endoscopic MAYO score ≥ 1) at initiation of therapy. Patients previously treated with vedolizumab or tofacitinib were excluded. Corticosteroid-free clinical remission (SCCAI<2), biochemical remission (CRP ≤5 mg/L and/or FC ≤250 µg/g) and safety outcomes were compared after 52 weeks of treatment. Inverse propensity scores weighted comparison was used to adjust for confounding and selection bias. Results Overall, 83 vedolizumab and 65 tofacitinib treated patients were included (table 1). Propensity score weighted analysis showed that tofacitinib treated patients were more likely to achieve corticosteroid-free clinical remission at week 12, 24 and 52 compared to vedolizumab treated patients (OR: 5.87, 95%CI:3.55–9.70, P<0.01, OR: 2.96, 95%CI: 1.85–4.73, P<0.01 and OR 2.96, 95%CI: 1.85–4.73, P<0.01, respectively) (table 2). In addition, tofacitinib treated patients were more likely to achieve biochemical remission at week 12 and week 24, remaining only statistically borderline at week 52 (OR: 2.96, 95%CI: 1.85–4.73, P<0.01, OR: 2.96, 95%CI: 1.85–4.73, P<0.01 and OR 1.68, 95%CI: 0.99–2.86, P=0.05, respectively) (table 2). There was no difference in infection rate (OR:1.057, 95%CI: 0.60–1.86, p=0.85) or severe adverse events (OR: 0.39, 95%CI: 0.03–4.33, P=0.44). No thromboembolic events were observed. Most common reason for treatment discontinuation was loss of response (table 3). Conclusion In tofacitinib treated, anti-TNF experienced, UC patients, we observed that a higher proportion of patients achieved corticosteroid-free remission after 12, 24 and 52 weeks compared to vedolizumab treated patients. In addition, more tofacitinib treated patients achieved biochemical remission at week 12 and 24. There was no statistically significant difference in severe adverse events.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- DOP75 Effectiveness and Safety of tofacitinib versus vedolizumab in Patients with Ulcerative Colitis; A Nationwide, ICC Registry study
- Date Crossref
- 01/01/2022
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Dutch Initiative on Crohn and Colitis pays non établi dans la noticeOrganisation à but non lucratif
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University Medical Center Groningen pays non établi dans la noticeÉtablissement de santé
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Erasmus MC pays non établi dans la noticeÉtablissement de santé
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University of Alberta pays non établi dans la noticeUniversité ou école supérieure
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Zuyderland Medisch Centrum pays non établi dans la noticeÉtablissement de santé
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Amphia Ziekenhuis pays non établi dans la noticeÉtablissement de santé
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Vrije Universiteit Amsterdam pays non établi dans la noticeUniversité ou école supérieure
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Rijnstate Hospital pays non établi dans la noticeÉtablissement de santé
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OLVG pays non établi dans la noticeÉtablissement de santé
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Meander Medisch Centrum pays non établi dans la noticeÉtablissement de santé
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Ziekenhuis Gelderse Vallei pays non établi dans la noticeÉtablissement de santé
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University Medical Center Utrecht pays non établi dans la noticeÉtablissement de santé
Dutch Initiative on Crohn and Colitis, University Medical Center Groningen et Erasmus MC, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.