Evaluation of Tofacitinib in Primary Sclerosing Cholangitis and Associated Colitis: A Multicenter, Retrospective Study

Schregel, Ida; Ramos, Guilherme Piovezani; Ioannou, Stephanie; Culver, Emma; Rkkila, Martti Fa; Schramm, Christoph

doi:10.1016/j.cgh.2023.01.014

Cited by 11 publications

(7 citation statements)

References 9 publications

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“…Tofacitinib: Concerning tofacitinib, the meta-analysis was based on a single study, primarily due to limitations in data availability. In the study conducted by Schregel et al [ 22 ], prolonged treatment with tofacitinib demonstrated a significant reduction in the ALP ratio from baseline to the latest follow-up (p = 0.011; n = 35). Upon adjusting for between-group variances, a statistically significant mean decrease in serum ALP from baseline during tofacitinib treatment was observed.…”

Section: Reviewmentioning

confidence: 98%

“…Although studies on tofacitinib could not be included in the meta-analysis due to differing data parameters, this medication appeared to demonstrate some reduction in baseline ALP levels. In the study conducted by Schregel et al [ 22 ], the initial baseline ALP was recorded at 276 U/L. The results indicated an estimated marginal decrease of -68 U/L in the group that continued the medication compared to a +39 U/L increase in the group that discontinued treatment.…”

Section: Reviewmentioning

confidence: 99%

“…Tofacitinib: In a multicenter retrospective study, Schregel et al [ 22 ] described the safety and efficacy of tofacitinib in patients with IBD-PSC. The median time of treatment was 20.4 months.…”

Section: Reviewmentioning

confidence: 99%

“…In contrast, the therapeutic landscape for IBD encompasses various established biological agents, including anti-TNF-α drugs (infliximab, adalimumab, golimumab, and certolizumab), adhesion molecule antagonists (natalizumab and vedolizumab), oral Janus kinase (JAK) inhibitors (tofacitinib and upadacitinib), and antiinterleukin (IL)-12/23 agents (ustekinumab). Studies evaluating these biologic agents in PSC-IBD patients have yielded diverse outcomes [14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Biologics in the Treatment of Primary Sclerosing Cholangitis Associated With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Huynh,

Rubtsov,

Khaing

2024

Cureus

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This is the first systematic review and meta-analysis that aims to address the scarcity of research on the use of biological therapy in primary sclerosing cholangitis-inflammatory bowel disease (PSC-IBD) and the historical inadequacy of therapeutic options. Its purpose is to investigate this matter comprehensively and furnish guidance for clinical practice. Utilizing Embase, PubMed, Medline, and clinicaltrials.gov studies investigating the roles of biologics and antibiotics in PSC-IBD were identified. The systematic literature review encompassed articles published from inception through September 2023. Two independent reviewers assessed the articles, and methodological quality was gauged using Review Manager 5.4.2. Nine studies were included in the systematic review and meta-analysis. However, only four met the criteria for inclusion in the meta-analysis due to variability and availability of data; the remaining studies underwent descriptive analysis. Notably, infliximab, adalimumab, vedolizumab, and tofacitinib showed ineffectiveness in reducing cholestatic markers. This review underscores the limited impact of biological and small-molecule therapies on disease progression in PSC-IBD patients, signifying the need for further exploration and development of treatment modalities in this domain.

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Section: Reviewmentioning

confidence: 98%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Biologics in the Treatment of Primary Sclerosing Cholangitis Associated With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Huynh,

Rubtsov,

Khaing

2024

Cureus

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“…Allerdings wurde über ein erhöhtes bakterielles Cholangitisrisiko unter Anti-TNF-Antikörpern (nicht aber unter Immunmodulatoren/Azathioprin) bei PSC berichtet [ 27 ]. Neuere immunologische/antiinflammatorische Therapieansätze wie JAK-Inhibitoren und Anti-IL-23-Strategien haben in Pilotstudien für Tofacitinib [ 28 ] erste positive Signale gezeigt und werden derzeit im Rahmen klinischer Studien noch weiter untersucht.…”

Section: Medikamentöse Therapieoptionenunclassified

Primär sklerosierende Cholangitis – Diagnose und Therapie 2024

Trauner,

Halilbasic,

Tatscher

et al. 2024

Innere Medizin

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ZusammenfassungDie Ursache der primär sklerosierenden Cholangitis (PSC) bleibt unklar und erklärt das Fehlen einer kausalen Therapie. Die differenzialdiagnostische Abgrenzung zur noch selteneren IgG4-assoziierten Cholangitis (IAC) gelingt uns immer besser. Fortschritte im Wissen um unterschiedliche klinische Verläufe, Verbesserungen in der nichtinvasiven Diagnostik durch moderne Magnetresonanzbildgebung und die Einführung der Leberelastographie führten zur Entwicklung verbesserter Prognosemodelle. Die Evidenz für Empfehlungen zur medikamentösen (z. B. Ursodesoxycholsäure) oder endoskopischen Therapie (z. B. Ballondilatation und/oder Stenteinlage) bei PSC bleibt gering. Hingegen werden die Langzeitergebnisse der Lebertransplantation bei PSC stetig besser. Mangels hochsensitiver und spezifischer Screeningmethoden gelingt die Früherkennung des cholangiozellulären Karzinoms (CCC) als wichtigste Komplikation selten. Die stetige Verbesserung von ERCP und direkter Cholangioskopie in Kombination mit molekularbiologischen und FISH-Analysen der gewonnenen Gewebsproben ist für die verfeinerte Diagnostik vielversprechend. Aufgrund des deutlich erhöhten Risikos für kolorektale Karzinome wird bei Vorliegen einer chronisch-entzündlichen Darmerkrankung (CED) die jährliche Koloskopie empfohlen. Errungenschaften in der Frühdiagnostik und die erfolgreiche Testung neuer Therapiemodalitäten lassen auf eine stetige Verbesserung in der Betreuung dieser komplexen PatientInnen hoffen.

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Tofacitinib

2024

Reactions Weekly

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Evaluation of Tofacitinib in Primary Sclerosing Cholangitis and Associated Colitis: A Multicenter, Retrospective Study

Cited by 11 publications

References 9 publications

Efficacy of Biologics in the Treatment of Primary Sclerosing Cholangitis Associated With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Efficacy of Biologics in the Treatment of Primary Sclerosing Cholangitis Associated With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Primär sklerosierende Cholangitis – Diagnose und Therapie 2024

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