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Tofacitinib-Associated Cerebral Venous Sinus Thrombosis
Zakaria Hakma1, Natalie Gofman1, Danielle Brown1
1Global Neurosciences Institute, Philadelphia, PA.
ACG Case Reports Journal
|July 26, 2021
Summary
Tofacitinib, a Janus kinase inhibitor for ulcerative colitis, may be linked to cerebral venous sinus thrombosis (CVST). This case report highlights a potential association, urging further investigation of thrombotic events in patients using this medication.
Area of Science:
- Gastroenterology
- Neurology
- Pharmacology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Tofacitinib is a Janus kinase (JAK) inhibitor approved for moderately to severely active UC.
- Thrombosis is a recognized adverse event associated with JAK inhibitors.
Observation:
- A 60-year-old male patient with poorly controlled UC developed cerebral venous sinus thrombosis (CVST).
- The patient experienced CVST involving the right transverse and sigmoid sinuses several months after initiating tofacitinib therapy.
- Initial hematological workup excluded other hypercoagulable conditions, with UC being the only identified comorbidity.
Findings:
- This case represents the first reported instance of CVST potentially associated with tofacitinib.
- The temporal relationship suggests a possible link between tofacitinib use and the development of CVST.
- No underlying hypercoagulable state was identified, strengthening the hypothesis of drug-induced thrombosis.
Implications:
- This case underscores the importance of monitoring for thrombotic events, including CVST, in patients treated with tofacitinib.
- Further research and data collection on all thrombotic events in patients receiving tofacitinib are warranted.
- Clinicians should consider the potential risk of CVST when prescribing tofacitinib for ulcerative colitis.
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