TY  - JOUR
Y1  - 2024///
VL  - 119
AV  - public
EP  - 1535
SP  - 1525
JF  - AMERICAN JOURNAL OF GASTROENTEROLOGY
UR  - https://doi.org/10.14309/ajg.0000000000002676
ID  - publicatio29494
A1  -  Dragoni Gabriele
A1  -  Innocenti Tommaso
A1  -  Amiot Aurelién
A1  -  Castiglione Fabiana
A1  -  Melotti Laura
A1  -  Festa Stefano
A1  -  Savarino Edoardo Vincenzo
A1  -  Truyens Marie
A1  -  Argyriou Konstantinos
A1  -  Noviello Daniele
A1  -  Molnár Tamás
A1  -  Bouillon Vincent
A1  -  Bezzio Cristina
A1  -  Eder Piotr
A1  -  Fernandes Samuel
A1  -  et al.
N2  - Patients with ulcerative colitis (UC) receiving immunosuppressive drugs are at substantial risk of colectomy. We aimed to assess the risk of post-operative complications of tofacitinib exposure before colectomy in comparison with biologics.A multicentre, retrospective, observational study was conducted in patients with UC who underwent total colectomy for medically refractory disease, exposed to tofacitinib or a biologic before surgery. Primary outcome was the occurrence of any complication within 30 (early) and 90 (late) days after surgery. Secondary outcomes were the occurrence of infections, sepsis, surgical site complications, venous thromboembolic events (VTE), hospital re-admissions, and redo surgery within the same timepoints.Three hundred and one patients (64 tofacitinib, 162 anti-TNFs, 54 vedolizumab, 21 ustekinumab) were included. No significant differences were reported in any outcome, except for a higher rate of early VTE with anti-TNFs (P=0.047) and of late VTE with vedolizumab (P=0.03). In the multivariate analysis, drug class was not associated with a higher risk of any early and late complications. Urgent colectomy increased the risk of any early (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.06-3.48) complications, early hospital re-admission (OR 4.79, 95%CI 1.12-20.58), and early redo surgery (OR 7.49, 95%CI 1.17-47.85). A high steroid dose increased the risk of any early complications (OR 1.96, 95%CI 1.08-3.57), early surgical site complications (OR 2.03, 95%CI 1.01-4.09), and early redo surgery (OR 7.52, 95%CI 1.42-39.82). Laparoscopic surgery decreased the risk of any early complications (OR 0.54, 95%CI 0.29-1.00), early infections (OR 0.39, 95%CI 0.18-0.85), and late hospital re-admissions (OR 0.34, 95%CI 0.12-1.00).Pre-operative tofacitinib treatment demonstrated a post-operative safety profile comparable to biologics in patients with UC undergoing colectomy.
TI  - Rates of adverse events in patients with ulcerative colitis undergoing colectomy during treatment with tofacitinib vs biologics
IS  - 8
SN  - 0002-9270
ER  -