Real-World Effectiveness and Safety of Selective JAK Inhibitors in Ulcerative Colitis and Crohn's Disease: A Retrospective, Multicentre Study

被引：0

作者：

Farkas, Bernadett ^{[1
]}

Bessissow, Talat ^{[2
]}

Limdi, Jimmy K. ^{[3
]}

Sethi-Arora, Karishma ^{[3
]}

Kagramanova, Anna ^{[4
,5
]}

Knyazev, Oleg ^{[4
,6
]}

Bezzio, Cristina ^{[7
,8
]}

Armuzzi, Alessandro ^{[7
,8
]}

Lukas, Milan ^{[9
]}

Michalopoulos, George ^{[10
]}

Chaskova, Elena ^{[11
,12
]}

Savarino, Edoardo Vincenzo ^{[13
,14
]}

Castiglione, Fabiana ^{[15
]}

Rispo, Antonio ^{[15
]}

Schafer, Eszter

Saibeni, Simone ^{[17
]}

Filip, Rafal ^{[18
]}

Attauabi, Mohamed ^{[19
]}

Fousekis, Fotios S. ^{[20
]}

Bacsur, Peter ^{[1
,21
]}

Resal, Tamas ^{[16
,21
]}

Balint, Anita ^{[1
]}

Ivany, Emese ^{[1
]}

Szepes, Zoltan ^{[1
]}

Bosze, Zsofia ^{[1
]}

Fabian, Anna ^{[1
]}

Bor, Renata ^{[1
]}

Farkas, Klaudia ^{[1
,21
]}

Lakatos, Peter L. ^{[2
,22
]}

Molnar, Tamas ^{[1
]}

机构：

[1] Univ Szeged, Ctr Gastroenterol, H-6725 Szeged, Hungary

[2] McGill Univ, Div Gastroenterol, Hlth Ctr, Montreal, PQ H4A 3J1, Canada

[3] Northern Care Alliance NHS Fdn Trust, Manchester M6 8HD, England

[4] Moscow Clin Sci Ctr, Moscow 111123, Russia

[5] Res Inst Hlth Org & Med Management, Moscow 115088, Russia

[6] State Sci Ctr Coloproctol, Moscow 123423, Russia

[7] IRCCS Human Res Hosp, IBD Ctr, I-20089 Milan, Italy

[8] Humanitas Univ, Dept Biomed Sci, I-20072 Milan, Italy

[9] Clin & Res Ctr Inflammatory Bowel Dis, Prague 19000, Czech Republic

[10] Gen Hosp Athens G Gennimatas, Athens 11527, Greece

[11] Irkutsk Reg Hosp, Dept Coloproctol, Irkutsk 664528, Russia

[12] Fed Sci Ctr Surg & Traumatol, Irkutsk 664003, Russia

[13] Azienda Osped Univ Padua, Gastroenterol Unit, Padua, Italy

[14] Univ Padua, Dept Surg Oncol & Gastroenterol, I-35124 Padua, Italy

[15] Univ Naples Federico II, Gastroenterol Dept Clin Med & Surg, I-80131 Naples, Italy

[16] Hungarian Def Forces Mil Hosp, Dept Gastroenterol, H-1062 Budapest, Hungary

[17] ASST Rhodense, Rho Hosp, Gastroenterol Unit, I-20017 Milan, Italy

[18] Clin Hosp 2, Dept Gastroenterol, IBD Unit, Rzeszow, Poland

[19] Copenhagen Univ Hosp Herlev & Gentofte, Dept Gastroenterol & Hepatol, DK-2730 Herlev, Denmark

[20] Univ Hosp Ioannina, Div Gastroenterol, Ioannina 45500, Greece

[21] HCEMM USZ Translat Colorectal Res Grp, H-6725 Szeged, Hungary

[22] Semmelweis Univ, Dept Internal Med & Oncol, H-1085 Budapest, Hungary

来源：

JOURNAL OF CLINICAL MEDICINE | 2024年 / 13卷 / 24期

基金：

欧盟地平线“2020”;

关键词：

ulcerative colitis; Crohn's disease; upadacitinib; filgotinib; JAK-inhibitors; MAINTENANCE THERAPY; DOUBLE-BLIND; UPADACITINIB; INDUCTION;

D O I：

10.3390/jcm13247804

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background/Objectives: Data on the real-world effectiveness and safety of selective JAK inhibitors (JAKis) in ulcerative colitis (UC) and Crohn's disease (CD) are limited. Methods: We conducted a multicentre, retrospective study to assess clinical, biochemical, and endoscopic outcomes of selective JAKis in bio-experienced UC and CD. Results: A total of 246 patients (mean age: 40.5 +/- 14.5 years; 131 UC and 115 CD) were included with a median follow-up of 7.5 months. Among the CD patients receiving upadacitinib (n = 115), 76.2% achieved clinical remission (CR) at week 12. Furthermore, 59.5% of the upadacitinib-treated UC patients (n = 100) experienced CR at week 8. Corticosteroid-free CR (CSFCR) was achieved by 76.9% of the CD patients and 80.6% of the UC patients at week 24, while 50.0% and 36.1% experienced endoscopic remission. At week 52, 66.7% of the CD and 86.2% of the UC patients achieved CSFCR, whereas 54.5% and 52.9% had endoscopic remission. In UC, the effectiveness of upadacitinib was not compromised by prior tofacitinib failure, while the upadacitinib-treated CD patients with stricturing and penetrating disease were less likely to achieve CR by the end of the induction phase (p = 0.04). C-reactive protein (p[CD] < 0.0001; p[UC] < 0.0001) and faecal calprotectin (p[CD] < 0.0001; p[UC] = 0.02) decreased significantly in both patient groups as early as week 2. Among the filgotinib-treated UC patients (n = 31), 28.6% were in CR at week 12. At week 24 and 52, 59.1% and 60% achieved CSFCR, while 0.0% and 20.0% had endoscopic remission. Both C-reactive protein (p = 0.04) and faecal calprotectin (p = 0.04) decreased significantly by week 12. Hyperlipidaemia (9.7-9.8%) was the most common adverse event. Conclusions: Selective JAKis are rapidly effective and safe for treating refractory, moderate-to-severe CD and UC.

引用

页数：19

共 38 条

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