Positioning Tofacitinib in the Treatment Algorithm of Moderate to Severe Ulcerative Colitis

Treatment options for ulcerative colitis (UC) remain limited because conventional therapies do not succeed at controlling the disease in a considerable percentage of patients, while up to 30% of those receiving biologics are primary nonresponders and 10%-20% lose response per year, requiring an increase in the treatment dose or the use of a different drug. Recently, tofacitinib, an orally administered small molecule that inhibits the Janus kinases, was proven efficacious for inducing and maintaining remission in adult patients with moderate to severe UC. Tofacitinib may represent a therapeutic alternative for the management of UC, pending approval by the US Food and Drug Administration, the European Medicines Agency, and other international regulatory authorities. Herein, we review tofacitinib's efficacy and safety data reported from randomized controlled trials in UC populations, with the aim to define how this new molecule could be inserted into the therapeutic algorithm of patients with UC.