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Tofacitinib-Associated Iatrogenic Kaposi Sarcoma in a Patient With Ulcerative Colitis

Panu Wetwittayakhlang1,2, Petra A Golovics1,3, Waqqas Afif1

  • 1Division of Gastroenterology, McGill University Health Center, Montreal, Canada.

ACG Case Reports Journal
|November 29, 2021
PubMed

Insights

Tofacitinib, a Janus kinase inhibitor for ulcerative colitis, has been linked to rare malignancies. A case of Kaposi sarcoma developed and resolved after discontinuing this medication, highlighting a potential safety concern.

Area of Science:

  • Gastroenterology
  • Oncology
  • Immunology

Background:

  • Tofacitinib is an oral Janus kinase (JAK) inhibitor used for moderate-to-severe ulcerative colitis.
  • While effective for remission, JAK inhibitors carry a risk of malignancy.
  • Ulcerative colitis itself is associated with an increased risk of certain cancers.

Observation:

  • A rare case of Kaposi sarcoma (KS) is presented.
  • The patient had complex, biologically resistant ulcerative colitis.
  • KS developed after two years of tofacitinib treatment.

Findings:

  • Biopsy-proven Kaposi sarcoma occurred in a patient treated with tofacitinib.
  • The Kaposi sarcoma lesions showed spontaneous regression upon tofacitinib discontinuation.
  • This suggests a potential causal link between tofacitinib and KS development.

Implications:

  • Healthcare providers should be aware of the rare but serious risk of Kaposi sarcoma with tofacitinib.
  • Monitoring for malignancies may be warranted in patients on long-term tofacitinib therapy.
  • Further research is needed to elucidate the mechanisms linking JAK inhibitors to KS.

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