Side Effects of tofacitinib: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Key Research Findings

Tofacitinib is a JAK inhibitor that has been studied for its potential to treat inflammatory bowel diseases, especially ulcerative colitis (UC). 7 Research suggests that tofacitinib could be a viable option for treating patients with steroid-refractory acute severe ulcerative colitis (ASUC), a condition that carries a high risk of colectomy. 7 While tofacitinib has shown promise in treating moderate to severe UC, further research is needed specifically for ASUC patients. 7

Tofacitinib has also been investigated for its potential to treat rheumatoid arthritis (RA). Studies indicate that tofacitinib can increase the frequency of senescent T cells in patients with RA and limit T cell function in vitro. 15 This suggests that tofacitinib may activate immunosenescence pathways while simultaneously inhibiting effector functions in T cells, which could contribute to both the drug's efficacy and potential side effects. 15

Researchers have also explored the use of tofacitinib for other inflammatory conditions like prurigo nodularis, psoriasis, and alopecia areata. 3 6 13 23

Reasons for Side Effects

Tofacitinib is an immunosuppressant, meaning it weakens the immune system. This can make the body more susceptible to infections. 21 Additionally, tofacitinib targets JAK enzymes, which are crucial for various cellular processes. Inhibiting these enzymes can lead to unintended consequences, such as T cell senescence and other adverse effects. 15

Common Side Effects

Infections

Tofacitinib is an immunosuppressant and can increase the risk of infections. 21

Weight Gain

Some patients taking tofacitinib have reported weight gain. 8

Eosinophilia

A rare side effect of tofacitinib is eosinophilia, an increase in the number of eosinophils (a type of white blood cell) in the blood. 10

Pemphigus

There is evidence suggesting a possible association between tofacitinib and pemphigus, an autoimmune blistering skin disease. 9

Countermeasures for Side Effects

Infections

It is important to monitor for any signs of infection, such as fever, chills, cough, or sore throat. 21 If you experience any of these symptoms, consult your doctor immediately. 21

Weight Gain

Maintaining a healthy diet and regular exercise can help mitigate weight gain. 8

Comparison between Studies

Commonalities of Studies

Most research highlights the potential of tofacitinib for treating inflammatory conditions, particularly autoimmune diseases. 7 15 3 6 13 23 However, there is also consistent evidence of side effects associated with tofacitinib, particularly related to its immunosuppressive nature. 21

Differences between Studies

The specific side effects reported, their severity, and frequency can vary depending on the study's focus, patient population, and research design. 9 10 8

Points to Note Regarding Real-Life Applications

Tofacitinib is a potent drug that can be effective in treating inflammatory conditions. However, the potential for side effects, especially those related to the immune system, should be carefully considered. Consult your doctor to discuss your individual health risks and benefits of taking tofacitinib. 21

Limitations of Current Research

While there is growing evidence on tofacitinib's efficacy and potential side effects, further research is necessary to fully understand its long-term safety and its impact on specific populations. 7 22 17

Future Research Directions

Future research should focus on improving the delivery methods of tofacitinib, potentially minimizing systemic exposure and reducing side effects. 14 16 Investigating the long-term safety of tofacitinib in diverse populations is crucial. 17 Developing better ways to manage or prevent side effects, such as infections and weight gain, would be beneficial. 21 8

Conclusion

Tofacitinib holds promise as a treatment for inflammatory bowel diseases and other inflammatory conditions. It's important to weigh the potential benefits against the risks, including the possibility of side effects like infections. As with any medication, consulting with your doctor is essential to determine if tofacitinib is right for you.

Literature analysis of 24 papers
Positive Content
23
Neutral Content
0
Negative Content
1
Article Type
1
0
1
4
21
1.

Safety and Effectiveness of Tofacitinib in Treating Polyarticular Course Juvenile Idiopathic Arthritis.

Author: JonesNicholas T, KellerCamryn L, AbadieRaegan B, BrattonMatthew B, HendersonEmmilee J, MoorePeyton, RiegerRoss, AhmadzadehShahab, TirumalaSridhar, VarrassiGiustino, ShekoohiSahar, KayeAlan D

pcJIA treatment
Immunocompromised patients
Renal and hepatic metabolism

This study examines the viability of tofacitinib, a JAK inhibitor, as a treatment for polyarticular course juvenile idiopathic arthritis (pcJIA). Tofacitinib has the potential to be effective in reducing flare-ups and lowering erythrocyte sedimentation rate in immunocompetent patients with pcJIA, especially those who are refractory to traditional treatments. However, more research is needed to determine its effectiveness in younger pediatric populations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Therapeutic potential of a synthetic dual JAK1/TYK2 inhibitor in inflammatory bowel disease.

Author: CuiXue, TengYaxin, HuYiguo, LiQingqing, PeiHeying, YangZhuang

High safety
IBD treatment
Low toxicity

The JAK1/TYK2 inhibitor, small molecule 18, demonstrated superior therapeutic effects in mouse models of ulcerative colitis compared to tofacitinib. It also exhibited a good safety profile after long-term administration.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Systemic Medication for the Treatment of Prurigo Nodularis-A Systematic Review.

Author: McCampbellLillian E, ZainoMallory L, RanpariyaManas, PatelTejesh, FeldmanSteven R

Prurigo nodularis treatment
Pruritus reduction
Muscle and nerve pain
Side effects

This review examined the efficacy of systemic treatments for prurigo nodularis. Dupilumab was found to be most effective with the fewest side effects. Thalidomide and pregabalin were also effective, but long-term use was limited by side effects. Janus kinase inhibitors may also be beneficial, but further research is needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Treatment of antibiotic refractory chronic pouchitis with JAK inhibitors and S1P receptor modulators: an ECCO CONFER Multicentre Case Series.

Author: RibaldoneDavide Giuseppe, TestaGiulia, VerstocktBram, MolnarTamas, SavarinoEdoardo, SchmidtCarsten, VieujeanSophie, TeichNiels, MeianuCorina, JuilleratPascal, GrellierNathan, LobatonTriana

CARP treatment

Small molecules, such as JAK inhibitors and S1P receptor modulators, may represent a suitable option for chronic pouchitis refractory to multiple biologics. In a retrospective study of 15 patients, 53.3% achieved a clinical response and 40% achieved clinical remission after 3 months of treatment with JAK inhibitors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Effectiveness of oral tofacitinib treatment on patients with moderate-to-severe alopecia areata in Iran.

Author: AsilianAli, MohammadianParisa, ShahmoradiZabihollah

Alopecia areata treatment
Unpredictable recovery

This study investigates the effectiveness of tofacitinib in treating alopecia areata, a challenging disease due to its unpredictable course and potential for spontaneous recovery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Topical Tofacitinib as Effective Therapy in Patients with Plaque Psoriasis Responsive to Systemic Drugs but with Resistant Nail Psoriasis.

Author: Berbert FerreiraRachel, Berbert FerreiraSineida, Neves NetoAfonso Cesar, Caparroz-AssefSilvana Maria, BricthaLars, DamianiGiovanni, IorizzoMatilde

Nail psoriasis treatment
None mentioned

This article highlights the need for novel modalities in treating nail psoriasis due to the limitations and side effects of current topical treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis.

Author: MalakarSayan, KothalkarSrikanth, Shamsul HodaUmair, GhoshalUday C

Bridge therapy for ASUC
Colectomy risk

Tofacitinib, a Janus kinase inhibitor, is a potential treatment option for steroid-refractory acute severe ulcerative colitis (ASUC), which carries a high risk of colectomy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

A case series on tofacitinib-induced weight gain.

Author: ShahKanisha, ShuklaDhaiwat, PatelManish, MalhotraSupriya

Rheumatic disease treatment
Weight gain

Tofacitinib, a Janus kinase inhibitor, is a drug used to treat inflammatory diseases. This report presents six cases of tofacitinib-induced weight gain in patients with ankylosing spondylitis, rheumatoid arthritis, and vasculitis, highlighting the potential for this rare side effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
CommentA short article/note that provides an opinion/perspective/interpretation on a published paper/topic.

Language : English

10.

Tofacitinib-induced eosinophilia.

Author: ArcherSara, FerreiraDaniela, FerreiraAna Teresa, PonteSofia, CaetanoCidalina, SalgadoMarta, LagoPaula, PedrotoIsabel

Effective UC treatment
Good safety profile
AKI
Eosinophilia

This case report describes an 18-year-old woman with ulcerative colitis (UC) who developed eosinophilia and acute kidney injury after starting tofacitinib, a JAK inhibitor. This rare adverse event highlights the importance of monitoring patients closely for potential side effects associated with tofacitinib.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Novel Small Molecules in IBD: Current State and Future Perspectives.

Author: JefremowAndré, NeurathMarkus F

Ease of use
Lack of immunogenicity
Low production costs
JAK inhibitor side effects
Potential side effects
S1P1R modulator side effects

Small molecules, such as JAK inhibitors and S1P1R modulators, are emerging as alternative therapies for inflammatory bowel diseases (IBDs), offering potential benefits over biological agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Efficacy and Safety of Tofacitinib in Patients with Polymyalgia Rheumatica (EAST PMR): An open-label randomized controlled trial.

Author: MaXinlei, YangFan, WuJinzhi, XuBei, JiangMengdi, SunYiduo, SunChuanying, YuYe, XuDanyi, XiaoLanlan, RenChunyun, ChenChunyan, YeZi, LiangJunyu, LinJin, ChenWeiqian

PMR treatment

Polymyalgia rheumatica (PMR) is a common inflammatory condition that affects older adults. While steroids are the main treatment, they can have side effects. We need to understand what causes PMR and find other treatments that can reduce the need for steroids. This study will examine the characteristics of PMR and investigate the effectiveness and safety of a medication called tofacitinib, which blocks a specific enzyme, in people with PMR.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Temperature-triggered in situ forming lipid mesophase gel for local treatment of ulcerative colitis.

Author: CaroneMarianna, SpalingerMarianne R, GaultneyRobert A, MezzengaRaffaele, HlavačkováKristýna, MookhoekAart, KrebsPhilippe, RoglerGerhard, LucianiPaola, AleandriSimone

Improved drug bioavailability
Reduced systemic exposure
Targeted delivery

This study presents a temperature-triggered in situ forming lipid gel for topical treatment of ulcerative colitis. The gel provides sustained release of drugs, adheres to the colonic wall, and improves animal health in colitis models.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Tofacitinib treatment of rheumatoid arthritis increases senescent T cell frequency in patients and limits T cell function in vitro.

Author: AlaminoVanina A, OnofrioLuisina I, AcostaCristina Del Valle, FerreroPaola V, ZaccaEstefanía R, CadileIsaac I, MussanoEduardo D, OnettiLaura B, MontesCarolina L, GruppiAdriana, Acosta RodriguezEva V

Treatment of rheumatoid arthritis
Immunosenescence
Inhibited T-cell function

This study identified T-cell profiles characterizing RA patients under specific treatments. The study found that tofacitinib-treated patients segregated from healthy donors at the expense of T-cell activation, differentiation, and effector function-related variables.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Comparisons of treatment satisfaction and health-related quality of life in patients with rheumatoid arthritis treated with tofacitinib and adalimumab.

Author: KimSeong-Kyu, LeeSang-Heon, SunJiyu, LeeSoo Hyun, JeonJa-Young, YooHyun-Jeong, ChoeJung-Yoon

RA HRQoL
RA treatment satisfaction

This study aimed to compare the treatment satisfaction and health-related quality of life (HRQoL) of patients with rheumatoid arthritis (RA) treated with tofacitinib and adalimumab in real-world settings in Korea. The study used propensity score methods to account for potential confounding factors. This research provides valuable insights into patient-reported outcomes for different RA treatments.

Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Current evidence and clinical relevance of drug-microbiota interactions in inflammatory bowel disease.

Author: BeckerHeike E F, DemersKarlijn, DerijksLuc J J, JonkersDaisy M A E, PendersJohn

IBD treatment
Drug side effects

This review provides a comprehensive overview of current evidence on bidirectional interactions between the microbiota and relevant IBD drugs (pharmacomicrobiomics).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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