medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-15-20-29medsovet-6415Research ArticleОригинальная статьяOriginal articleЭффективность и безопасность тофацитиниба при язвенном колите средней и тяжелой степени в реальной клинической практике: три года наблюденияEfficacy and safety of tofacitinib in moderate and severe ulcerative colitis in real clinical practice: three years of observationhttps://orcid.org/0000-0001-7250-0977КнязевО. В.KnyazevO. V.

д.м.н., профессор, заведующий отделением лечения воспалительных заболеваний кишечника;  профессор научнообразовательного отдела; ведущий специалист организационно-методического отдела по колопроктологии

111123, Москва, Шоссе Энтузиастов, д. 86; 123423,  Москва,ул. Саляма Адиля, д. 2; 115088, Москва, ул. Большая Татарская, д. 30

Dr. Sci. (Med.), Professor, Head of the Department for the Treatment of Inflammatory Bowel Diseases; Professor of the Scientific and Educational Department; Leading Specialist of the Organizational and MethodologicalDepartment for coloproctology

86, Entuziastov Shosse, Moscow, 111123; Salyam Adil St., Moscow, 123423; 30, B. Tatarskaya St., Moscow, 115088

oleg7@bk.ruhttps://orcid.org/0000-0002-3818-6205КаграмановаА. В.KagramanovaA. V.

111123, Москва, Шоссе Энтузиастов, д. 86

Cand. Sci. (Med.), Senior Researcher

86, Entuziastov Shosse, Moscow, 111123

https://orcid.org/0000-0001-7891-2702ЛищинскаяА. А.LishchinskayaA. A.

111123, Москва, Шоссе Энтузиастов, д. 86

 Cand. Sci. (Med.), Senior Researcher

86, Entuziastov Shosse, Moscow, 111123

 

lalbiba@inbox.ruhttps://orcid.org/0000-0002-9508-7502ЛиИ. А.LiI. A.

111123, Москва, Шоссе Энтузиастов, д. 86

 Dr. Sci. (Med.), Chief Physician

86, Entuziastov Shosse, Moscow, 111123

i.li@mknc.ruhttps://orcid.org/0000-0001-5694-1051ПодольскаяД. В.PodolskayaD. V.

123423,  Москва, ул. Саляма Адиля, д. 2

Junior Researcher, Department of Gastroenterology 

 2, Salyam Adil St., Moscow, 123423

dashamed2014@gmail.comhttps://orcid.org/0000-0002-7502-2437ШкуркоТ. В.ShkurkoT. V.

123423,  Москва, ул. Саляма Адиля, д. 2; 115088, Москва, ул. Большая Татарская, д. 30

Cand. Sci. (Med.), Head of  the  Organizational and Methodological Department for  Coloproctology

2, Salyam Adil St., Moscow, 1234234 ; 30, B. Tatarskaya St., Moscow, 115088

shkurkotania@yandex.ruhttps://orcid.org/0000-0003-1697-4670НанаеваБ. А.NanaevaB. A.

123423,  Москва, ул. Саляма Адиля, д. 2

Cand. Sci. (Med.), Head of the Department of Gastroenterology  

2, Salyam Adil St., Moscow, 123423

nanaeva1987@mail.ruhttps://orcid.org/0000-0002-8803-7566АлександровТ. Л.AleksandrovT. L.

123423,  Москва, ул. Саляма Адиля, д. 2

 Junior Researcher, Department of Gastroenterology

2, Salyam Adil St., Moscow, 123423

alexandrov_tl@mail.ruhttps://orcid.org/0000-0003-2013-8798БарановаТ. А.BaranovaT. A.

123423,  Москва, ул. Саляма Адиля, д. 2

Junior Researcher, Department of Gastroenterology

 2, Salyam Adil St., Moscow, 123423

tatya-ar@yandex.ruТишаеваИ. А.TishaevaI. A.

123423,  Москва, ул. Саляма Адиля, д. 2

 Junior Researcher, Department of Gastroenterology  

 2, Salyam Adil St., Moscow, 123423

tishaeva.i@yandex.ruhttps://orcid.org/0000-0002-7937-2346ЗвягловаМ. Ю.ZvyaglovaM. Yu.

111123, Москва, Шоссе Энтузиастов, д. 86

Junior Researcher, Department of Inflammatory Bowel Diseases

86, Entuziastov Shosse, Moscow, 111123

zwmr306@mail.ruhttps://orcid.org/0000-0002-9782-4860ПарфёновА. И.ParfenovA. I.

111123, Москва, Шоссе Энтузиастов, д. 86

 Dr. Sci. (Med.), Professor, Head of the Department of Intestinal Pathology 

86, Entuziastov Shosse, Moscow, 111123

asfold@mail.ruМосковский клинический научно-практический центр имени А.С. Логинова; Национальный медицинский исследовательский центр колопроктологии имени А.Н. Рыжих; Научно-исследовательский институт организации здравоохранения и медицинского менеджментаРоссияLoginov Moscow Clinical Scientific Center; Ryzhikh State Scientific Center of Coloproctology; Research Institute of Health Organization and Medical ManagementRussian FederationМосковский клинический научно-практический центр имени А.С. ЛогиноваРоссияLoginov Moscow Clinical Scientific CenterRussian FederationНациональный медицинский исследовательский центр колопроктологии имени А.Н. РыжихРоссияRyzhikh State Scientific Center of ColoproctologyRussian FederationНациональный медицинский исследовательский центр колопроктологии имени А.Н. Рыжих; Научно-исследовательский институт организации здравоохранения и медицинского менеджментаРоссияRyzhikh State Scientific Center of Coloproctology; Research Institute of Health Organization and Medical ManagementRussian Federation2021161020210152029Copyright © Князев О.В., Каграманова А.В., Лищинская А.А., Ли И.А., Подольская Д.В., Шкурко Т.В., Нанаева Б.А., Александров Т.Л., Баранова Т.А., Тишаева И.А., Звяглова М.Ю., Парфёнов А.И., 20212021Князев О.В., Каграманова А.В., Лищинская А.А., Ли И.А., Подольская Д.В., Шкурко Т.В., Нанаева Б.А., Александров Т.Л., Баранова Т.А., Тишаева И.А., Звяглова М.Ю., Парфёнов А.И.Knyazev O.V., Kagramanova A.V., Lishchinskaya A.A., Li I.A., Podolskaya D.V., Shkurko T.V., Nanaeva B.A., Aleksandrov T.L., Baranova T.A., Tishaeva I.A., Zvyaglova M.Y., Parfenov A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6415Введение

Введение. Тофацитиниб (ТФЦБ) – первый представитель нового класса таргетных синтетических противовоспалительных препаратов для лечения язвенного колита (ЯК). В статье представлен трехлетний российский опыт применения ТФЦБ для лечения умеренного и тяжелого ЯК.

Цель

Цель. Оценить эффективность и безопасность терапии ТФЦБ в реальной клинической практике у больных ЯК средней и тяжелой степени в течение трех лет наблюдения.

Материалы и  методы

Материалы и  методы. В  исследование включены 56  пациентов с  ЯК, которые имели среднетяжелое (60,7%) и  тяжелое (35,8%) течение заболевания, у 67,8% диагностировано тотальное поражение, у 57,1% пациентов – внекишечные проявления. Оценивались раннее достижение клинического ответа, клинической и эндоскопической, бесстероидной ремиссии, безопасность.

 Результаты

 Результаты. Ранний ответ на терапию ТФЦБ получен у 47 (83,9%) пациентов. У 36 (64,3%) на 8-й неделе терапии была достигнута клиническая ремиссия, у 13 (23,2%) пациентов – клинический ответ. Большинство пациентов, достигших клинической ремиссии на 8-й и 12-й неделях, достигли заживления слизистой оболочки толстой кишки на 24-й неделе. Показатели клинической и  клинико-эндоскопической ремиссии через 24  нед.: 44  (78,6%) пациента, клинический ответ у  7  (12,5%) пациентов, 5 (8,9%) не ответили на терапию ТФЦБ. Бесстероидная ремиссия составила 77,6%. Через 2 года терапии ТФЦБ ремиссия ЯК сохранялась у 46 (82,1%). Через 36 мес. ремиссия ЯК сохранялась у 45 (80,3%) пациентов из 56, которым была начата терапия ТФЦБ. Кумулятивный эффект выживаемости при лечении ТФЦБ при ЯК составил 87,5% через 6 мес. и сохранялся в течение года, 82,1% – через 2 года, 80,3% – через 3 года.

Выводы

Выводы. Применение ТФЦБ при ЯК эффективно в отношении достижения быстрого клинического ответа, клинической ремиссии и заживления слизистой у больных, недостаточно отвечающих на биологическую терапию.

Introduction

Introduction. Tofacitinib is the first member of a new class of targeted synthetic anti-inflammatory drugs for the treatment of ulcerative colitis (UC). The article presents a three-year Russian experience of tofacitinib use for the treatment of moderate and severe UC.

Aim of the study

Aim of the study. To evaluate the efficacy and safety of tofacitinib therapy in real clinical practice in moderate to severe UC patients during three years of follow-up.  

Methods

Methods. The study included 56 patients with UC who had moderate (60.7%) and severe (35.8%) states of disease, the total lesion was diagnosed in 67.8%, and extraintestinal manifestations in 57.1% of patients. Early achievement of clinical response, clinical and endoscopic, corticosteroid-free remission, and safety were evaluated.

Results

Results. Early response to tofacitinib therapy was obtained in 47 (83.9%) patients. Clinical remission was achieved in 36 (64.3%) at week 8 of therapy and clinical response was achieved in 13 (23.2%) patients. The majority of patients who achieved clinical remission at weeks 8 and 12 achieved healing of colon mucosa at week 24. Clinical and endoscopic remission rates after 24 weeks – 44 (78.6%) patients, clinical response in 7 (12.5%) patients, 5 (8.9%) did not respond to TFCB therapy. Corticosteroidfree remission was 77.6%. After 2 years of tofacitinib therapy, remission of UC was maintained in 46 (82.1%). After 36 months, remission of UC was maintained in 45 (80.3%) of the 56 patients who had been started on tofacitinib therapy. The cumulative effect of survival in the treatment of tofacitinib in UC was 87.5% after 6 months and persisted for one year, 82.1% after 2 years, and 80.3% after 3 years.

Conclusions

Conclusions. The administration of tofacitinib in UC is effective in achieving rapid clinical response, clinical remission, and mucosal healing in patients who do not respond well to biological therapy. 

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The authors declare that there are no conflicts of interest present.