OBJECTIVES: Tofacitinib is a Janus Kinase inhibitor used for treating moderate to severe ulcerative colitis (UC), mainly after the failure of biological therapy. There is a paucity of data on the outcome of tofacitinib in biological-naïve UC patients. The present study was aimed at analyzing the safety and efficacy of tofacitinib in biological-naïve Indian patients with UC. METHODS: The present study retrospectively evaluated consecutive patients with biological-naïve moderate-to-severe active UC from six tertiary care centers in India receiving tofacitinib from September 2020 to September 2022. Clinical remission or response assessment was based on partial Mayo score (PMS) calculated at baseline and weeks eight, 16 and 24. RESULTS: Total 47 cases (57.4% male, median age: 32 years) were included. After eight weeks of therapy, 33 (70.2%) achieved clinical remission and eight (17.0%) had a primary failure. The baseline serum albumin at treatment initiation was the only independent predictor of remission at eight weeks (Odds ratio: 11.560, 95% CI: 1.478 - 90.404), but not at 16 weeks. By 24 weeks, 59.6% (28/47) of the patients were in remission and 29.8% (14/47) had stopped tofacitinib either due to failure (27.6%) or adverse events (AEs) (2.1%). Among the 47 patients, 10 (21.2%) cases developed AEs during follow-up, including two tuberculosis (4.2%), one cytomegalovirus (CMV) colitis (2.1%) and one herpes zoster (2.1%). Four patients with infection required temporary drug discontinuations. One required permanent discontinuation (mania). CONCLUSION: Upfront tofacitinib is effective in biologic-naïve Indian patients with moderate-severe UC. Further randomized studies are required to validate the study findings.
Colitis, Ulcerative , Piperidines , Pyrimidines , Humans , Male , Adult , Female , Colitis, Ulcerative/drug therapy , Protein Kinase Inhibitors/adverse effects , Retrospective Studies , Pyrroles/adverse effects , Treatment Outcome
Acute Kidney Injury , Liver Transplantation , Reperfusion Injury , Humans , Liver Transplantation/adverse effects , Reperfusion Injury/etiology , Reperfusion Injury/prevention & control , Kidney , Biomarkers , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Acute Kidney Injury/prevention & control , Ischemia
Hepatitis, Alcoholic , Liver Transplantation , Mucormycosis , Opportunistic Infections , Humans , Liver Transplantation/adverse effects , Hepatitis, Alcoholic/complications , Hepatitis, Alcoholic/surgery , Antifungal Agents/therapeutic use , Gastrointestinal Hemorrhage/etiology , Lower Gastrointestinal Tract , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , Opportunistic Infections/etiology , Mucormycosis/drug therapy
Hepatitis, Alcoholic , Hepatorenal Syndrome , Terlipressin , Vasoconstrictor Agents , Humans , Hepatitis, Alcoholic/complications , Hepatitis, Alcoholic/drug therapy , Hepatorenal Syndrome/complications , Hepatorenal Syndrome/drug therapy , Lypressin/adverse effects , Terlipressin/therapeutic use , Treatment Outcome , Vasoconstrictor Agents/therapeutic use
Familial clustering of hepatitis B virus infection has been reported infrequently. We report a family of 27 members, where 13 members were HBsAg-positive. This included 7 of 10 members in one linear family across four generations. Nine subjects who were tested were HBeAg-negative. Of these nine, three subjects had elevated ALT; histology in one of them showed activity index <3. One subject received lamivudine therapy elsewhere; ALT levels returned to normal in two months.
Hepatitis B/genetics , Adolescent , Adult , Child , Cluster Analysis , Female , Hepatitis B Surface Antigens/analysis , Humans , Male , Middle Aged , Pedigree
