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Impact of Concomitant Corticosteroids on Tofacitinib Induction Efficacy and Infection Rates in Ulcerative Colitis.


ABSTRACT:

Background

Tofacitinib is an oral small molecule Janus kinase inhibitor for the treatment of ulcerative colitis.

Aim

To report efficacy and infection rates in patients receiving tofacitinib induction treatment, by baseline corticosteroid status.

Methods

We evaluated efficacy and safety data from OCTAVE Induction 1&2 in patients with moderately-to-severely active ulcerative colitis who received tofacitinib 10 mg twice daily or placebo for 8 weeks, based on induction baseline oral corticosteroid use (Corticosteroid-Yes/No) and dose (< 20/ ≥ 20 mg/day). Infections of interest included serious infections, herpes zoster (HZ), and adjudicated opportunistic infections (OIs).

Results

At OCTAVE Induction 1&2 baseline, 478/1092 (43.8%) patients were receiving corticosteroids. Tofacitinib demonstrated significant induction efficacy versus placebo for both Corticosteroid-Yes and Corticosteroid-No. With adjustment for prior tumor necrosis factor inhibitor and immunosuppressant failure, there were no statistically significant differences in remission and clinical response rates for Corticosteroid-Yes versus Corticosteroid-No. Among tofacitinib-treated patients, HZ and OIs occurred more frequently in Corticosteroid-Yes versus Corticosteroid-No, regardless of dose (< 20 mg vs. ≥ 20 mg). Infection incidence rates (regardless of severity/seriousness) during tofacitinib induction were generally similar regardless of baseline corticosteroid use. The proportion of tofacitinib-treated patients with HZ was 0.2% for Corticosteroid-No versus 1.1% for Corticosteroid-Yes < 20 mg and 1.0% for Corticosteroid-Yes ≥ 20 mg. Two out of three patients had HZ OIs.

Conclusions

Tofacitinib induction efficacy (clinical response and remission) was similar in baseline corticosteroid subgroups. Infections of interest were rare; HZ and OIs occurred more frequently among those receiving tofacitinib and corticosteroids versus those receiving tofacitinib without corticosteroids.

Trial registration

http://www.

Clinicaltrials

gov (NCT01465763[21/10/2011]; NCT01458951[21/10/2011]).

SUBMITTER: Lichtenstein GR 

PROVIDER: S-EPMC9899108 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Impact of Concomitant Corticosteroids on Tofacitinib Induction Efficacy and Infection Rates in Ulcerative Colitis.

Lichtenstein Gary R GR   Cohen Benjamin L BL   Salese Leonardo L   Modesto Irene I   Wang Wenjin W   Chan Gary G   Ahmed Haytham Mohamed HM   Su Chinyu C   Peyrin-Biroulet Laurent L  

Digestive diseases and sciences 20230204 6


<h4>Background</h4>Tofacitinib is an oral small molecule Janus kinase inhibitor for the treatment of ulcerative colitis.<h4>Aim</h4>To report efficacy and infection rates in patients receiving tofacitinib induction treatment, by baseline corticosteroid status.<h4>Methods</h4>We evaluated efficacy and safety data from OCTAVE Induction 1&2 in patients with moderately-to-severely active ulcerative colitis who received tofacitinib 10 mg twice daily or placebo for 8 weeks, based on induction baseline  ...[more]

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