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Tofacitinib-induced eosinophilia

2023-12Journal article Open access
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dc.contributor.authorArcher, Sara
dc.contributor.authorFerreira, Daniela
dc.contributor.authorFerreira, Ana Teresa
dc.contributor.authorPonte, Sofia
dc.contributor.authorCaetano, Cidalina
dc.contributor.authorSalgado, Marta
dc.contributor.authorLago, Paula
dc.contributor.authorPedroto, Isabel
dc.date.accessioned2024-07-18T14:55:22Z
dc.date.available2024-07-18T14:55:22Z
dc.date.issued2023-12
dc.description.abstractTofacitinib is an oral small molecule JAK inhibitor approved for the treatment of moderate to severe ulcerative colitis (UC). Its efficacy and safety have been demonstrated in phase III clinical trials and supported by real-life data. We report the case of an 18-year-old woman with a 1-year diagnosis of left-sided UC, with multiple admissions due to disease exacerbation or infections, refractory to infliximab (with azathioprine) and currently under treatment with vedolizumab and tacrolimus. She was admitted due to a severe disease exacerbation and, because of a previous history of neuropsychiatric side effects to corticotherapy, tofacitinib was initiated. In the following 6 days, there was no clinical improvement of UC, and serial blood work-up revealed moderate grade persistent peripheral eosinophilia (3000 cells/mm3) and acute kidney injury grade 1 KDIGO. Tofacitinib temporary suspension was decided, with a rapid normalization of renal function/eosinophil levels. Tofacitinib was restarted 2 days after its suspension. However, she developed moderate eosinophilia (2000 cells/mm3) again, which was considered an adverse effect (AE) to tofacitinib, leading to its suspension with eosinophilia resolution. Given the severity of the disease, after a multidisciplinary discussion, it was decided to start high-dose corticotherapy and ustekinumab with maintenance therapy every 4 weeks, and to add tacrolimus. Clinical and biochemical remission were achieved, and the patient was discharged. Three-month follow-up after tofacitinib suspension showed no recrudescence of eosinophilia. Tofacitinib represents a significant advance in the management of UC patients. The drug has a good safety profile with few related AE. This case aims to warn about an adverse reaction to tofacitinib not reported so far, including in a multicenter real-life setting recently published by Hernández et al where eosinophilia is also not described, thus emphasizing the rarity of this AE. To our knowledge this is the first case of tofacitinib-induced eosinophilia in the context of UC.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationArcher S, Ferreira D, Ferreira AT, et al. Tofacitinib-induced eosinophilia. Rev Esp Enferm Dig. 2023;115(12):742. doi:10.17235/reed.2023.9831/2023pt_PT
dc.identifier.doi10.17235/reed.2023.9831/2023pt_PT
dc.identifier.issn1130-0108
dc.identifier.urihttp://hdl.handle.net/10400.16/3008
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAran Edicionespt_PT
dc.relation.publisherversionhttps://www.reed.es/ArticuloFicha.aspx?id=13180&hst=0&idR=127&tp=1pt_PT
dc.titleTofacitinib-induced eosinophiliapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceSpainpt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage742pt_PT
oaire.citation.titleRevista Española de Enfermedades Digestivaspt_PT
oaire.citation.volume115pt_PT
person.familyNameSalgado
person.familyNameLAGO VIEIRA DOS SANTOS
person.familyNamePedroto
person.givenNameMarta
person.givenNamePAULA MARIA
person.givenNameIsabel
person.identifier.ciencia-id511B-A7C6-ACE2
person.identifier.ciencia-id5514-3FC4-9C62
person.identifier.orcid0000-0003-2088-7932
person.identifier.orcid0000-0001-6573-699X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication046cdc4a-d116-49ea-ad24-3972a2416350
relation.isAuthorOfPublicationabe823e2-57bc-45ab-9ab5-a59cfe48dab5
relation.isAuthorOfPublicatione523f164-bf0d-4248-8069-53df9d926349
relation.isAuthorOfPublication.latestForDiscovery046cdc4a-d116-49ea-ad24-3972a2416350

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