Introduction: Tofacitinib (Tc) has demonstrated promising efficacy in treating patients with moderate-severe ulcerative colitis (UC). However, its safety in the elderly population is not well-documented, as they are often underrepresented in clinical trials.
Methods: In this multicenter retrospective cohort study of patients with UC presenting to tertiary care locations (OH, FL) between January 2018 to August 2023, patients were classified into young (< 50) or old (≥50 years) at the time of receiving Tc. Exclusion criteria included alternative causes of colitis, Tc indication other than UC or combination of biologics. The primary outcome was colectomy at 52-week follow up point. Secondary outcomes included hospitalization, treatment change, treatment discontinuation and mortality.
Results: 804 patients were screened and 103 patients (71 young, 32 old) were included in the final analysis (Figure 1.1). Baseline characteristics of the study population were obtained (Table 1). The mean age at Tc initiation was 61.25 years in the older group and 25.82 years in the younger group. Higher Charlson score was seen in the older group (2.69 vs 0.2667, p< 0.0001), however; baseline UC severity, phenotype and duration were similar for both groups. The primary outcome of colectomy was also similar between both groups. Among the secondary outcomes, there was no increase in the number hospitalizations after Tc or treatment discontinuation at 52-week follow up (Figure 1.1). A higher rate of discontinuation secondary to treatment failure was observed in the elderly but this did not reach statistical significance (Figure 1.2). In the univariate analysis, age at Tc and Charlson score were not associated with higher risk of colectomy (Figure 1.3).
Discussion: The risk of colectomy in older patients with UC on Tc is similar to that in younger patients, and similar causes of treatment discontinuation and rates of compliance is seen between both groups.
Figure: Figure 1.1: Treatment Discontinuation Rate of Study Participants. Figure 1.2: Reasons for Tofacitinib Discontinuation Among Study Participants. Figure 1.3: Univariate Analysis for Predictors of Colectomy Among Patients on Tofacitinib.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Osama Sherjeel Khan indicated no relevant financial relationships.
Ashraf Almomani indicated no relevant financial relationships.
Mohamad-Noor Abu-Hammour indicated no relevant financial relationships.
Rashid Abdel-Razeq indicated no relevant financial relationships.
Ritu Channagiri indicated no relevant financial relationships.
Zaid Ansari indicated no relevant financial relationships.
Akram Ahmad indicated no relevant financial relationships.
Asif Hitawala indicated no relevant financial relationships.
Fernando Castro indicated no relevant financial relationships.
Asad Ur Rahman indicated no relevant financial relationships.
Osama Sherjeel Khan, MD1, Ashraf Almomani, MD1, Mohamad-Noor Abu-Hammour, MD2, Rashid Abdel-Razeq, MD3, Ritu NA. Channagiri, BS1, Zaid Ansari, MD1, Akram Ahmad, MD1, Asif Hitawala, MD4, Fernando NA. Castro, MD1, Asad Ur Rahman, MD1. P0947 - Risk of Colectomy and Treatment Discontinuation in Patients on Tofacitinib Among Young vs Old Patients with Ulcerative Colitis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
