背景:托法替尼适用于中度至重度溃疡性结肠炎(UC)患者;然而,鉴于其快速起效,对于住院的严重急性UC患者,它可能是另一种选择.文献中关于这种指示的数据很少。本研究的目的是描述托法替尼在治疗住院UC患者中的疗效和安全性。以及其临床特点和其他治疗模式。
方法:2019年6月至2022年12月在哥伦比亚对接受托法替尼治疗的CUAG成人和儿童进行描述性观察研究。收集社会人口统计学和临床变量,评估不同时间段的治疗反应,并对定量和定性变量进行描述性分析.
结果:6名患者(5名成人和1名儿童),平均年龄33.2(标准差8.5)岁,CUAG。在托法替尼开始后第7天,100%的患者获得了症状缓解。在三名患者中,获得了超过6个月的信息,100%临床,生物化学,和内窥镜缓解,不需要结肠切除术。在儿科患者的情况下,开始托法替尼后一周症状缓解,留在临床上,生化和内镜缓解超过6个月。在任何情况下均未报告严重不良事件。
结论:Tofacitinib代表了CUAG的抢救治疗替代方案,具有快速的临床反应,足够的耐受性和较少的结肠切除术的需要,持续超过6个月。
BACKGROUND: Tofacitinib is indicated in patients with moderate to severe ulcerative colitis (UC); however, given its rapid onset of action, it may constitute an alternative in patients with hospitalized severe acute UC. There are few data on this indication in the literature. The aim of this study was to describe the efficacy and safety of tofacitinib in the management of patients with hospitalized UC, as well as its clinical characteristics and other treatment patterns.
METHODS: Descriptive observational study of adults and children with CUAG treated with tofacitinib between June 2019 and December 2022 in Colombia. Sociodemographic and clinical variables were collected, therapeutic response was evaluated in different periods of time and descriptive analysis of quantitative and qualitative variables was performed.
RESULTS: Six patients (five adults and one pediatric), mean age 33.2 (SD: 8.5) years, with CUAG. Symptom remission was obtained in 100% of patients at day 7 after tofacitinib initiation. In three patients information was obtained beyond 6 months, with 100% clinical, biochemical, and endoscopic remission and without requiring colectomy. In the
case of the pediatric patient, symptom remission was achieved one week after starting tofacitinib, remaining in clinical, biochemical and endoscopic remission beyond 6 months. No serious adverse events were reported in any of the cases.
CONCLUSIONS: Tofacitinib represents a rescue therapeutic alternative in CUAG, with rapid clinical response, adequate tolerance and less need for colectomy, being sustained for periods beyond 6 months.