Study Compares AEs Associated With Tofacitinib vs Biologics Before Colectomy

Preoperative tofacitinib treatment showed a postoperative safety profile similar to biologics among patients with ulcerative colitis (UC) undergoing colectomy, researchers reported in The American Journal of Gastroenterology.

In a multicenter, retrospective study, researchers assessed the risk of postoperative complications in patients with UC who received tofacitinib or biologics before undergoing total colectomy for medically refractory disease. The study included 301 patients: 64 treated with tofacitinib, 162 with anti-tumor necrosis factor-α (TNF-α) agents, 54 with vedolizumab, and 21 with ustekinumab. The primary outcome measured was the occurrence of any complications within 30 (early) and 90 (late) days postsurgery. Secondary outcomes included infections, sepsis, surgical site complications, venous thromboembolic events (VTE), hospital readmissions, and the need for redo surgery.

Results indicated no significant differences in most postoperative outcomes between patients treated with tofacitinib and those treated with biologics. However, there was a higher rate of early VTE in patients receiving anti-TNF-α agents (P = 0.047) and late VTE in those treated with vedolizumab (P = 0.03). In multivariate analysis, the type of drug class was not associated with an increased risk of early or late complications.

Notably, urgent colectomy was linked to a higher risk of early complications, hospital readmission, and redo surgery. Additionally, high steroid doses before surgery increased the risk of early complications, surgical site issues, and the need for redo surgery. Finally, laparoscopic surgery was associated with a decreased risk of early complications, infections, and late hospital readmissions.

Reference
Dragoni G, Innocenti T, Amiot A, et al. Rates of adverse events in patients with ulcerative colitis undergoing colectomy during treatment with tofacitinib vs biologics: A multicenter observational study. Am J Gastroenterol. 2024;119(8):1525-1535. doi:10.14309/ajg.0000000000002676