Abstract
Abstract Background The efficacy of Tofacitinib (TOFA) in several rheumatic diseases led to expectations on a possible benefit of this drug for the treatment of ulcerative colitis (UC)-associated spondyloarthropathy (SpA). Methods Real-world Effectiveness of Tofacitinib on Ulcerative Colitis Associated Spondyloarthropathy (RETUCAS) is a prospective, multicentre, observational study designed to assess the effectiveness of TOFA on UC-associated SpA and promoted by the Italian Group for the study of Inflammatory Bowel Disease (IG-IBD). Patients with UC and an established diagnosis of active axial or peripheral SpA at baseline were included. The primary endpoint was the steroid-free joint response (SFJR - defined by a decrease of ≥ 1.1 units of ASDAS-CRP for axial SpA, and a decrease of > 0.6 units of DAS28-CRP for peripheral SpA compared with baseline with no steroids use) at week 8 and 52. Results Forty-four patients were included [axial Spa: 9.1%; peripheral SpA: 70.4%; combined axial and peripheral (mixed) SpA: 20.5%]. At 8 weeks, SFJR was reported in 52.3.% of patients, with a significant difference between patients with peripheral SpA compared with the subgroup of patients with axial and mixed SpA (67.7% vs. 15.4%; p=0.001). At 52 weeks, SFJR was reported in 59.1% of patients (peripheral SpA: 71.0% vs. axial and mixed SpA: 30.8%; p=0.01). Conclusion This is the first prospective study designed specifically for the assessment of IBD-associated SpA and based on rheumatological scores. In patients with UC and multiple previous therapeutic failures, TOFA was effective on peripheral SpA, while more data are needed on axial SpA.
Published Version
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