Xeljanz (tofacitinib) is the first FDA approved biologic pill. Other current biologics require intravenous infusion or injection, so the convenience of a pill could be life changing to treat those with moderate to severe UC. This medication first was approved in 2019, and has been under close watch by health care professionals and the IBD community. Many are still skeptical of its safety and effectiveness. Now we have several randomized controlled trial studies that have been conducted. These show that 52.2% of patients that had no improvement by week 8, achieved a clinical response just a few weeks later. This is a promising start, especially for those that have tried other biologic medications with no response.Â
Patients who failed to respond to a previous biologic were studied given 10mg of tofacitinib twice a day. These studies aimed to measure its safety and efficacy. For that reason, they were conducted for 16 weeks, then checked at 12 months and 36 months. These scientists found that after 12 months that 70.3% of delayed responders maintained clinical response, 56.8% maintained endoscopic improvement, and 44.6% maintained remission. At 36 months the values are 56.1%, 52%, and 44.6% sequentially. We see a bit of a drop, but the numbers presented are quite impressive, and many are hopeful for the future of this biologic.Â
And as far as safety? In these trials no additional side effects were identified at the 16-week mark that weren’t at the 8-week mark. While some complications like worsening of rheumatoid arthritis and blood clots were seen in patients 50 and older, minimal side effects were recorded for otherwise healthy patients under 50. This comes as very promising news for UC patients! While more long-term studies will be conducted, Xeljanz will pave the way for more pill versions of biologics in the near future, giving better treatment options for those with UC.      Â
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