PMID- 34516458
OWN - NLM
STAT- MEDLINE
DCOM- 20221017
LR  - 20230914
IS  - 1539-2031 (Electronic)
IS  - 0192-0790 (Linking)
VI  - 56
IP  - 10
DP  - 2022 Nov-Dec 01
TI  - Effectiveness and Safety of Tofacitinib for Ulcerative Colitis: Systematic Review 
      and Meta-analysis.
PG  - e323-e333
LID - 10.1097/MCG.0000000000001608 [doi]
AB  - BACKGROUND: The objective of our systematic review and meta-analysis was to 
      evaluate the effectiveness and safety of tofacitinib in the treatment of 
      moderate-severe ulcerative colitis (UC). METHODS: We searched Medline, Embase, 
      Web of Science, and Cochrane Central to identify articles and abstracts reporting 
      efficacy or safety data on tofacitinib use in UC. Primary outcome assessed was 
      remission. Secondary outcomes included clinical response, steroid free remission, 
      and adverse events (AEs). RESULTS: A total of 26 studies were included. The rates 
      of remission were 29.81% [95% confidence interval (CI): 22.37%-37.25%, I2 : 90%] 
      at week 8, 32.27% (95% CI: 27.67%-36.88%, I2 : 42%) at 6 months and 38.03% (95% 
      CI: 33.59%-42.48%, I2 : 0%) at 1-year. Clinical response rates were 59.41% (95% 
      CI: 55.03%-63.94%, I2 : 61%) at week 8, 48.99% (95% CI: 36.92%-61.06%, I2 : 91%) 
      at 6 months and 50.87% (95% CI: 42.16%-59.58%, I2 : 67%) at 1-year. Odds ratio of 
      clinical response at week 8 in biologic naive versus biologic experienced 
      patients was 1.59 (95% CI: 0.54-4.63). Pooled incidence rate for serious 
      infections, major adverse cardiovascular events, and nonmelanotic squamous cell 
      malignancies across all doses was 4.41 per 100-patient years (PYs) (95% CI: 
      2.32-8.38 per 100-PY, I2 : 78%), 0.91 per 100-PY (95% CI: 0.43-1.93 per 100-PY, 
      I2 : 37%) and 0.91 per 100-PY (95% CI: 0.61-1.34 per 100-PY, I2 : 0%), 
      respectively. Higher dose was associated with an increased frequency of AEs. 
      CONCLUSIONS: While the overall efficacy and safety of tofacitinib in 
      moderate-severe UC is consistent with clinical trial data, the dose dependent 
      increase in AEs highlights the significance of early dose de-escalation. Rate of 
      clinical response after tofacitinb induction was similar in biologic naive and 
      biologic experienced patients.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Taneja, Vikas
AU  - Taneja V
AD  - Section of Hospital Medicine.
FAU - El-Dallal, Mohammed
AU  - El-Dallal M
AD  - Division of Gastroenterology and Center for Inflammatory Bowel Diseases.
AD  - Cambridge Health Alliance, Cambridge.
FAU - Haq, Zadid
AU  - Haq Z
AD  - Johns Hopkins University School of Medicine, Bayview Medical Residency, 
      Baltimore, MD.
FAU - Tripathi, Kartikeya
AU  - Tripathi K
AD  - University of Massachusetts Medical School-Baystate Campus, Springfield, MA.
FAU - Systrom, Hannah K
AU  - Systrom HK
AD  - Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical 
      School.
FAU - Wang, Linda F
AU  - Wang LF
AD  - Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical 
      School.
FAU - Said, Hyder
AU  - Said H
AD  - Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical 
      School.
FAU - Bain, Paul A
AU  - Bain PA
AD  - Countway Library, Harvard Medical School, Boston.
FAU - Zhou, Youlian
AU  - Zhou Y
AD  - Division of Gastroenterology and Center for Inflammatory Bowel Diseases.
FAU - Feuerstein, Joseph D
AU  - Feuerstein JD
AD  - Division of Gastroenterology and Center for Inflammatory Bowel Diseases.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210909
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (Biological Products)
RN  - 0 (Piperidines)
RN  - 0 (Pyrimidines)
RN  - 87LA6FU830 (tofacitinib)
SB  - IM
CIN - J Clin Gastroenterol. 2023 Apr 01;57(4):429. PMID: 36728526
MH  - *Biological Products/therapeutic use
MH  - *Colitis, Ulcerative/drug therapy
MH  - Humans
MH  - Piperidines/adverse effects
MH  - Pyrimidines/adverse effects
EDAT- 2021/09/14 06:00
MHDA- 2022/10/18 06:00
CRDT- 2021/09/13 17:24
PHST- 2021/03/11 00:00 [received]
PHST- 2021/07/24 00:00 [accepted]
PHST- 2021/09/14 06:00 [pubmed]
PHST- 2022/10/18 06:00 [medline]
PHST- 2021/09/13 17:24 [entrez]
AID - 00004836-202211000-00002 [pii]
AID - 10.1097/MCG.0000000000001608 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 2022 Nov-Dec 01;56(10):e323-e333. doi: 
      10.1097/MCG.0000000000001608. Epub 2021 Sep 9.