Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis

Background: ulcerative colitis is a chronic inflammatory disease of the colon for which current treatments are not universally effective. One additional treatment may be tofacitinib (CP-690,550), an oral inhibitor of Janus kinases 1, 2, and 3 with in vitro functional specificity for kinases 1 and 3...

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Autores: Sandborn, William J., Ghosh, Subrata, Panés Díaz, Julià, Vranic, Ivana, Su, Chinyu, Rousell, Samantha, Niezychowski, Wojciech, Guardiola, Jordi, Study A3921063 Investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/178620
Acceso en línea:https://hdl.handle.net/2445/178620
Access Level:acceso abierto
Palabra clave:Colitis ulcerosa
Proteïnes quinases
Pirimidines
Pirroles
Ulcerative colitis
Protein kinases
Pyrimidines
Pyrroles
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spelling Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitisSandborn, William J.Ghosh, SubrataPanés Díaz, JuliàVranic, IvanaSu, ChinyuRousell, SamanthaNiezychowski, WojciechGuardiola, JordiStudy A3921063 InvestigatorsColitis ulcerosaProteïnes quinasesPirimidinesPirrolesUlcerative colitisProtein kinasesPyrimidinesPyrrolesBackground: ulcerative colitis is a chronic inflammatory disease of the colon for which current treatments are not universally effective. One additional treatment may be tofacitinib (CP-690,550), an oral inhibitor of Janus kinases 1, 2, and 3 with in vitro functional specificity for kinases 1 and 3 over kinase 2, which is expected to block signaling involving gamma chain-containing cytokines including interleukins 2, 4, 7, 9, 15, and 21. These cytokines are integral to lymphocyte activation, function, and proliferation. Methods: in a double-blind, placebo-controlled, phase 2 trial, we evaluated the efficacy of tofacitinib in 194 adults with moderately to severely active ulcerative colitis. Patients were randomly assigned to receive tofacitinib at a dose of 0.5 mg, 3 mg, 10 mg, or 15 mg or placebo twice daily for 8 weeks. The primary outcome was a clinical response at 8 weeks, defined as an absolute decrease from baseline in the score on the Mayo scoring system for assessment of ulcerative colitis activity (possible score, 0 to 12, with higher scores indicating more severe disease) of 3 or more and a relative decrease from baseline of 30% or more with an accompanying decrease in the rectal bleeding subscore of 1 point or more or an absolute rectal bleeding subscore of 0 or 1. Results: the primary outcome, clinical response at 8 weeks, occurred in 32%, 48%, 61%, and 78% of patients receiving tofacitinib at a dose of 0.5 mg (P=0.39), 3 mg (P=0.55), 10 mg (P=0.10), and 15 mg (P<0.001), respectively, as compared with 42% of patients receiving placebo. Clinical remission (defined as a Mayo score ≤2, with no subscore >1) at 8 weeks occurred in 13%, 33%, 48%, and 41% of patients receiving tofacitinib at a dose of 0.5 mg (P=0.76), 3 mg (P=0.01), 10 mg (P<0.001), and 15 mg (P<0.001), respectively, as compared with 10% of patients receiving placebo. There was a dose-dependent increase in both low-density and high-density lipoprotein cholesterol. Three patients treated with tofacitinib had an absolute neutrophil count of less than 1500. Conclusions: patients with moderately to severely active ulcerative colitis treated with tofacitinib were more likely to have clinical response and remission than those receiving placebo. (Funded by Pfizer; ClinicalTrials.gov number, NCT00787202).Massachusetts Medical Society2021202120122021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion9 p.application/pdfhttps://hdl.handle.net/2445/178620Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1056/NEJMoa1112168New England Journal of Medicine, 2012, vol. 367, num. 7, p. 616-624https://doi.org/10.1056/NEJMoa1112168(c) Massachusetts Medical Society, 2012info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1786202026-05-29T05:05:01Z
dc.title.none.fl_str_mv Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
title Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
spellingShingle Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
Sandborn, William J.
Colitis ulcerosa
Proteïnes quinases
Pirimidines
Pirroles
Ulcerative colitis
Protein kinases
Pyrimidines
Pyrroles
title_short Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
title_full Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
title_fullStr Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
title_full_unstemmed Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
title_sort Tofacitinib, an oral janus kinase inhibitor, in active ulcerative colitis
dc.creator.none.fl_str_mv Sandborn, William J.
Ghosh, Subrata
Panés Díaz, Julià
Vranic, Ivana
Su, Chinyu
Rousell, Samantha
Niezychowski, Wojciech
Guardiola, Jordi
Study A3921063 Investigators
author Sandborn, William J.
author_facet Sandborn, William J.
Ghosh, Subrata
Panés Díaz, Julià
Vranic, Ivana
Su, Chinyu
Rousell, Samantha
Niezychowski, Wojciech
Guardiola, Jordi
Study A3921063 Investigators
author_role author
author2 Ghosh, Subrata
Panés Díaz, Julià
Vranic, Ivana
Su, Chinyu
Rousell, Samantha
Niezychowski, Wojciech
Guardiola, Jordi
Study A3921063 Investigators
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Colitis ulcerosa
Proteïnes quinases
Pirimidines
Pirroles
Ulcerative colitis
Protein kinases
Pyrimidines
Pyrroles
topic Colitis ulcerosa
Proteïnes quinases
Pirimidines
Pirroles
Ulcerative colitis
Protein kinases
Pyrimidines
Pyrroles
description Background: ulcerative colitis is a chronic inflammatory disease of the colon for which current treatments are not universally effective. One additional treatment may be tofacitinib (CP-690,550), an oral inhibitor of Janus kinases 1, 2, and 3 with in vitro functional specificity for kinases 1 and 3 over kinase 2, which is expected to block signaling involving gamma chain-containing cytokines including interleukins 2, 4, 7, 9, 15, and 21. These cytokines are integral to lymphocyte activation, function, and proliferation. Methods: in a double-blind, placebo-controlled, phase 2 trial, we evaluated the efficacy of tofacitinib in 194 adults with moderately to severely active ulcerative colitis. Patients were randomly assigned to receive tofacitinib at a dose of 0.5 mg, 3 mg, 10 mg, or 15 mg or placebo twice daily for 8 weeks. The primary outcome was a clinical response at 8 weeks, defined as an absolute decrease from baseline in the score on the Mayo scoring system for assessment of ulcerative colitis activity (possible score, 0 to 12, with higher scores indicating more severe disease) of 3 or more and a relative decrease from baseline of 30% or more with an accompanying decrease in the rectal bleeding subscore of 1 point or more or an absolute rectal bleeding subscore of 0 or 1. Results: the primary outcome, clinical response at 8 weeks, occurred in 32%, 48%, 61%, and 78% of patients receiving tofacitinib at a dose of 0.5 mg (P=0.39), 3 mg (P=0.55), 10 mg (P=0.10), and 15 mg (P<0.001), respectively, as compared with 42% of patients receiving placebo. Clinical remission (defined as a Mayo score ≤2, with no subscore >1) at 8 weeks occurred in 13%, 33%, 48%, and 41% of patients receiving tofacitinib at a dose of 0.5 mg (P=0.76), 3 mg (P=0.01), 10 mg (P<0.001), and 15 mg (P<0.001), respectively, as compared with 10% of patients receiving placebo. There was a dose-dependent increase in both low-density and high-density lipoprotein cholesterol. Three patients treated with tofacitinib had an absolute neutrophil count of less than 1500. Conclusions: patients with moderately to severely active ulcerative colitis treated with tofacitinib were more likely to have clinical response and remission than those receiving placebo. (Funded by Pfizer; ClinicalTrials.gov number, NCT00787202).
publishDate 2012
dc.date.none.fl_str_mv 2012
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/178620
url https://hdl.handle.net/2445/178620
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1056/NEJMoa1112168
New England Journal of Medicine, 2012, vol. 367, num. 7, p. 616-624
https://doi.org/10.1056/NEJMoa1112168
dc.rights.none.fl_str_mv (c) Massachusetts Medical Society, 2012
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Massachusetts Medical Society, 2012
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 9 p.
application/pdf
dc.publisher.none.fl_str_mv Massachusetts Medical Society
publisher.none.fl_str_mv Massachusetts Medical Society
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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