The following article is a part of conference coverage from the 2019 Advances in Inflammatory Bowel Diseases (AIBD) Meeting, being held in Orlando, Florida. The team at MPR will be reporting on the latest news and research conducted by leading experts gastroenterology. Check back for more from the 2019 AIBD Meeting.
According to findings from a retrospective single-center observational study in patients with ulcerative colitis (UC), tofacitinib, a Janus kinase inhibitor, was associated with improved short-term efficacy, when compared with vedolizumab, an integrin receptor antagonist. Findings were presented at the Advances in Inflammatory Bowel Disease (AIBD) 2019 meeting in Orlando, Florida.
In order to better understand short-term outcomes with these therapies, study authors used real-world clinical data to assess remission rate and response rate at 2 and 6 weeks in UC patients initiated on tofacitinib (n=38) or vedolizumab (n=28). Remission was defined as a partial Mayo score of ≤1 point, while response included a partial Mayo score of ≤1 point or a decrease of ≥ 3 points. No significant clinical background factors were observed between the 2 groups (ie, clinical duration, relapse-remission type, colitis type), however, the authors noted that the severity of UC was greater in the tofacitinib group.
Results showed that at week 2, the remission rates were 23.7% for tofacitinib compared with 28.5% for vedolizumab (P =.654), while at week 6, remission rates increased to 39.4% with tofacitinib and 32.1% with vedolizumab (P =.611). The response rates were 50.0% vs 35.7% (P =.248) at week 2 and 63.2% vs 35.7% (P =.027) at week 6 for tofacitinib and vedolizumab, respectively.
Moreover, response rate at week 6 was observed to be significantly higher among patients with previous biologic failure who were treated with tofacitinib compared with vedolizumab (58.6% vs 21.4%); those with severe UC tended to have greater response with tofacitinib as well (56.7% vs 23.1% with vedolizumab).
With regard to safety, no serious treatment-emergent adverse events were observed in either group including pulmonary embolism.
“In the present study, tofacitinib tended to have a higher short-term efficacy regardless of the severity of the disease and the previous usage of biologics,” the authors concluded. They added that “further head-to-head study is required to extend these findings and determine the appropriate therapeutic options in terms of long-term efficacy and safety.”
Takeda, Y et al; The comparison of short-term efficacy of treatments between tofacitinib and vedolizumab in patients with ulcerative colitis. Presented at: 2019 AIBD Annual Meeting; December 12-14; Orlando, FL.