ABSTRACT
BACKGROUND: Tofacitinib is a selective immunosuppressant, the first representative of the inhibitors of the janus kinase family, which has high selectivity against other kinases of the human genome. According to the results of the study, tofacitinib inhibits JAK-1, JAK-2, and in high concentrations - JAK-3 and tyrosine kinase-2. The drug is registered in Russia for the treatment of patients with ulcerative colitis. According to the OCTAVE Sustain study, steroid-free remission in patients with ulcerative colitis receiving tofacitinib at a dose of 10 and 20 mg per day is 27.7% and 27.6%, respectively. OBJECTIVE: To identify the frequency of steroid-free remission in patients with ulcerative colitis receiving tofacitinib in real clinical practice. METHODS: In the Department of Inflammatory Bowel Diseases of the Moscow Clinical Scientific and Practical Center named after A. S. Loginov, 58 patients with ulcerative colitis (UC) who received tofacitinib were observed. The effectiveness of therapy was evaluated (the value of the Mayo index less than 2, ESR, CRP, hemoglobin, fecal calprotectin (FCP) and the need for the appointment of glucocorticosteroids (GCS). The follow-up period was 12 months from the start of tofacitinib therapy. RESULTS: During the follow-up period, out of 58 (100%) UC patients treated with tofacitinib, 9 (15.5%) patients did not respond to therapy. A prolonged induction course at a dose of 20 mg of tofacitinib was required in 14 (24.1%) patients who had previously received anti-TNF-α drugs. All patients at the time of initiation received GCS at an average therapeutic dose of 40 mg. After the induction course, corticosteroids were discontinued in 49 (100%) patients who responded to treatment. All patients achieved remission within 12 months of therapy (Meyo < 2). Repeated administration of corticosteroids for exacerbation or "eluding" of the response to tofacitinib was required in 11 of 49 (22.4%) patients. CONCLUSION: Steroid-free remission in patients with ulcerative colitis, receiving tofacitinib for 12 months, in real clinical practice is 77.6%.
