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Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis

BACKGROUND: The aim of the study was to assess the efficacy and safety of tofacitinib and its impact on quality of life in patients with moderate-to-severe ulcerative colitis. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials comparing tofacitinib with place...

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Autores principales: Paschos, Paschalis, Katsoula, Anastasia, Giouleme, Olga, Sarigianni, Maria, Liakos, Aris, Athanasiadou, Eleni, Bekiari, Eleni, Tsapas, Apostolos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102462/
https://www.ncbi.nlm.nih.gov/pubmed/30174394
http://dx.doi.org/10.20524/aog.2018.0276
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author Paschos, Paschalis
Katsoula, Anastasia
Giouleme, Olga
Sarigianni, Maria
Liakos, Aris
Athanasiadou, Eleni
Bekiari, Eleni
Tsapas, Apostolos
author_facet Paschos, Paschalis
Katsoula, Anastasia
Giouleme, Olga
Sarigianni, Maria
Liakos, Aris
Athanasiadou, Eleni
Bekiari, Eleni
Tsapas, Apostolos
author_sort Paschos, Paschalis
collection PubMed
description BACKGROUND: The aim of the study was to assess the efficacy and safety of tofacitinib and its impact on quality of life in patients with moderate-to-severe ulcerative colitis. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials comparing tofacitinib with placebo or any active comparator. We searched Medline, Embase, the Cochrane Library and gray literature for articles published up to May 2017. We synthesized data using a fixed-effect model. We conducted subgroup analysis based on prior exposure to anti-tumor necrosis factor (TNF). We summarized the strength of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: We included three trials with 1220 participants. Compared with placebo, tofacitinib was effective in inducing clinical remission (odds ratio [OR] 3.84, 95% confidence interval [CI] 2.29-6.44, I(2:) 41%, GRADE: moderate), clinical response (OR 2.95, 95%CI 2.21-3.95, I(2:) 0%, GRADE: high), mucosal healing (OR 2.70, 95%CI 1.81-4.03, I(2:) 0%, GRADE: high). Tofacitinib was effective in both anti-TNF-naïve and -experienced patients. Tofacitinib had a favorable effect on quality of life. There were no significant differences in the safety profile in terms of the incidence of any or serious adverse events compared to placebo. The risk for infections was increased (OR 1.51, 95%CI 1.05-2.19, I(2:) 0%, GRADE: moderate), but the incidence of serious infections did not differ between tofacitinib and placebo. CONCLUSION: In patients with moderate-to-severe ulcerative colitis, short-term treatment with tofacitinib is effective for induction of remission and improvement of quality of life.
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spelling pubmed-61024622018-09-01 Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis Paschos, Paschalis Katsoula, Anastasia Giouleme, Olga Sarigianni, Maria Liakos, Aris Athanasiadou, Eleni Bekiari, Eleni Tsapas, Apostolos Ann Gastroenterol Original Article BACKGROUND: The aim of the study was to assess the efficacy and safety of tofacitinib and its impact on quality of life in patients with moderate-to-severe ulcerative colitis. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials comparing tofacitinib with placebo or any active comparator. We searched Medline, Embase, the Cochrane Library and gray literature for articles published up to May 2017. We synthesized data using a fixed-effect model. We conducted subgroup analysis based on prior exposure to anti-tumor necrosis factor (TNF). We summarized the strength of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: We included three trials with 1220 participants. Compared with placebo, tofacitinib was effective in inducing clinical remission (odds ratio [OR] 3.84, 95% confidence interval [CI] 2.29-6.44, I(2:) 41%, GRADE: moderate), clinical response (OR 2.95, 95%CI 2.21-3.95, I(2:) 0%, GRADE: high), mucosal healing (OR 2.70, 95%CI 1.81-4.03, I(2:) 0%, GRADE: high). Tofacitinib was effective in both anti-TNF-naïve and -experienced patients. Tofacitinib had a favorable effect on quality of life. There were no significant differences in the safety profile in terms of the incidence of any or serious adverse events compared to placebo. The risk for infections was increased (OR 1.51, 95%CI 1.05-2.19, I(2:) 0%, GRADE: moderate), but the incidence of serious infections did not differ between tofacitinib and placebo. CONCLUSION: In patients with moderate-to-severe ulcerative colitis, short-term treatment with tofacitinib is effective for induction of remission and improvement of quality of life. Hellenic Society of Gastroenterology 2018 2018-05-10 /pmc/articles/PMC6102462/ /pubmed/30174394 http://dx.doi.org/10.20524/aog.2018.0276 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Paschos, Paschalis
Katsoula, Anastasia
Giouleme, Olga
Sarigianni, Maria
Liakos, Aris
Athanasiadou, Eleni
Bekiari, Eleni
Tsapas, Apostolos
Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
title Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
title_full Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
title_fullStr Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
title_full_unstemmed Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
title_short Tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
title_sort tofacitinib for induction of remission in ulcerative colitis: systematic review and meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102462/
https://www.ncbi.nlm.nih.gov/pubmed/30174394
http://dx.doi.org/10.20524/aog.2018.0276
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