MedPath

Tofacitinib in Adult Patients With Moderate to Severe Ulcerative Colitis

Recruiting
Conditions
Ulcerative Colitis
Interventions
Registration Number
NCT04424303
Lead Sponsor
Pfizer
Brief Summary

This is an observational prospective study with two years of follow-up, designed to evaluate the effectiveness of tofacitinib in patients with moderate to severe ulcerative colitis in French clinical practice

Detailed Description

TO FAst is a non-interventional study in France with primary objective to describe the clinical benefit of tofacitinib 1 year after its initiation for the treatment of moderate to severe UC in routine clinical practice. The study will also make it possible to report the clinical benefit 2 years after its initiation, to search for predictors of clinical benefit, improve our understanding of the efficacy of treatment in a real-life setting (in terms of response and speed of response), describe the characteristics of patients starting a treatment by tofacitinib, its real-life patterns of use as well as patient adherence to treatment.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
280
Inclusion Criteria
  • Patients of 18 years old or above
  • Patients with confirmed diagnosis of moderate to severe ulcerative colitis
  • Patients for whom gastroenterologist decides to initiate treatment with tofacitinib as per the French SmPC
  • Patients informed about the study procedures and receiving an information letter signed by the investigator
Exclusion Criteria
  • Patients who have already received tofacitinib treatment before baseline
  • Patients that fulfill any of the contrindications according to the latest version of the SmPC

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients prescribed tofacitinibTofacitinibPatients with a confirmed diagnosis of moderate to severe ulcerative colitis initiating tofacitinib as per the French summary of product characteristics (SmPC).
Primary Outcome Measures
NameTimeMethod
Proportion of patients with clinical benefit one year after initiation of tofacitinib treatment.Week 52

The definition of clinical benefit is independent of the discontinuation or not of tofacitinib treatment during the observation period.

Clinical benefit at year is defined on the basis of symptomatic remission evaluated with the PRO2 score ≤1 (absence of rectal bleeding and a stool frequency score between 0 and 1)\*. Patients who died or who had a colectomy or used another biologic/anti-JAK/immunosuppressant will be considered to be non-responders, as well as patients who used oal corticosteroids for UC, (regardless of the treatment duration) during the 3 months preceding the end of the observation period.

The clinical benefit of tofacitinib is independent of the administration or not of 5-ASA, or corticosteroids (not complying with the above definition) during the observation period (between 0 and 1 year).

Secondary Outcome Measures
NameTimeMethod
Proportion of patients with clinical benefit of tofacitinib at 2 yearsweek 104
Predictors of the clinical benefit at one year identified from the available baseline dataWeek 52
Proportion of patients in clinical remission and still receiving tofacitinibWeek 52 and Week 104

Clinical remission is defined as partial Mayo score (PMS) \<2

Proportion of patients in clinical remission without corticosteroids (oral or topical with systemic effects for UC)Week 52 and week 104
Proportion of patients with short-term clinical response for patients still treated with tofacitinibApproximately week 8 and 16

Clinical response is defined as a reduction in partial Mayo score ≥ 3 points and ≥ 30% with respect to baseline, with a concomitant reduction in rectal bleeding sub-score ≥ 1 point (absolute sub-score of 0 or 1).

Proportion of patients with biological response during the observation periodWeek 52 and 104

Biological response is defined as 50% reduction in the initial value of CRP or Fecal Calprotectine (FCP)

Proportion of patients with endoscopic improvement during the observation periodWeek 52 and 104

endoscopic improvement is defined as endoscopic subscore of 0 or 1

Proportion of patients in sustained clinical remissionWeek 52 and 104

Clinical remission is defined as partial Mayo score (PMS) \<2 at 52 and 104 weeks

Description of the changes in the rectal bleeding and stool frequency subscores during the first 2 weeks after initiation of tofacitinib therapy14 days

(self-assessment by patients)

Change in patient quality-of-life evaluated from the SIBDQ questionnaire between baseline and 1 year, baseline and 2 years, and between 1 and 2 yearsWeek 52, Week 52 to week 104 and week 104
Change in adherence to tofacitinib treatment during each visitWeek 8, 16, 24, 72, 52, 104

Using MARS questionnaire

Proportion of patients with serious and non-serious adverse events.Week 8, 16, 24,72,52 and 104
Time to loss of response to tofacitinib treatment in patients after dose reduction to 5 mg BID at the end of inductionWeek 8, 16, 24, 72, 52 and 104

The clinical loss of response is defined by a recrudescence of the symptoms that lead to a systemic therapeutic intervention (return to previous dose of tofacitinib or corticosteroid therapy, or an immunosuppressant or biologic/other anti-JAK)

Proportion of patients with extraintestinal manifestations at each visitWeek 8, 16, 24, 72, 52, 104
Proportion of patients with a colectomy during study follow-up and time of occurrenceWeek 8, 16, 24, 72,52 and 104
Characteristics of patients and UC, on the basis of all the data collected at baselineWeek 104

Trial Locations

Locations (38)

Clinique de l Europe

🇫🇷

Amiens, France

Hopital D'Estaing

🇫🇷

Clermont Ferrand, France

Hopital Sud

🇫🇷

Amiens, France

Hopital de La Cote de Nacre

🇫🇷

Caen, France

Hopital Jean Minjoz

🇫🇷

Besancon, France

Centre Hospitalier de Cahors

🇫🇷

Cahors, France

Ch Intercommunal de Creteil

🇫🇷

Creteil Cedex, France

Ch Dunkerque

🇫🇷

Dunkerque, France

Chu Nantes

🇫🇷

Nantes, France

Infirmerie Protestante de Lyon

🇫🇷

Caluire, France

Ch Bicetre

🇫🇷

Le Kremlin Bicetre, France

Hopital Europeen Georges Pompidou

🇫🇷

Paris, France

Hopital Trousseau

🇫🇷

Chambray Les Tours, France

Aphp - Hopital Beaujon

🇫🇷

Clichy Cedex, France

Hopital de L'Archet

🇫🇷

Nice, France

Hopital Caremeau

🇫🇷

Nimes, France

Hopital Albert Michallon

🇫🇷

La Tronche, France

CH Le Mans

🇫🇷

Le Mans, France

Ch Emile Roux

🇫🇷

Le Puy En Velay, France

Hopital Claude Huriez

🇫🇷

Lille, France

Ch Montfermeil

🇫🇷

Montfermeil, France

Ch Saint Joseph Saint Luc

🇫🇷

Lyon, France

Hopital Saint Eloi

🇫🇷

Montpellier Cedex 5, France

Clinique Beau Soleil

🇫🇷

Montpellier, France

Clinique Pasteur

🇫🇷

Toulouse, France

Groupe Hospitalier Mutualiste Les Portes du Sud

🇫🇷

Venissieux, France

Clinique Jules Verne

🇫🇷

Nantes, France

Aphp - Hopital Saint Louis

🇫🇷

Paris Cedex 10, France

Ch Valenciennes

🇫🇷

Valenciennes, France

Groupe Hospitalier Saint Joseph

🇫🇷

Paris, France

Chu Bichat Claude Bernard

🇫🇷

Paris, France

Chu de Bordeaux - Hopital Haut Leveque

🇫🇷

Pessac, France

CHU LYON

🇫🇷

Pierre Benite, France

Ch Annecy Genevois

🇫🇷

Pringy, France

Chu Rennes

🇫🇷

Rennes, France

Hopital Nord

🇫🇷

St Priest En Jarez Cedex, France

Ch Valence

🇫🇷

Valence, France

Hopital Rangueil

🇫🇷

Toulouse cedex 04, France

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