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Positioning of tofacitinib in treatment of ulcerative colitis: a global perspective

Shubhra Mishra1, Anuraag Jena2, Rinkalben Kakadiya2

  • 1Department of Gastroenterology, Asian Institute of Gastroenterology Hospitals, Hyderabad, India.

Expert Review of Gastroenterology & Hepatology
|July 25, 2022
PubMed
Abstract

Insights

Tofacitinib offers a cost-effective treatment option for ulcerative colitis (UC) when other therapies fail. Caution is advised for specific patient groups due to potential risks like infections and cardiovascular issues.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Immunology

Background:

  • Ulcerative colitis (UC) treatment requires cost-effective, non-immunogenic drugs with favorable safety profiles.
  • Tofacitinib presents a potential therapeutic option for UC patients.
  • Existing therapies may be ineffective or poorly tolerated by some UC patients.

Purpose of the Study:

  • To evaluate the existing literature on tofacitinib for ulcerative colitis treatment.
  • To determine the appropriate positioning of tofacitinib within the current therapeutic landscape.
  • To identify patient subsets requiring cautious use of tofacitinib.

Main Methods:

  • Literature review of available studies on tofacitinib in ulcerative colitis.
  • Analysis of efficacy, safety, and cost-effectiveness data.
  • Assessment of tofacitinib's role compared to conventional and biologic therapies.

Main Results:

  • Tofacitinib is effective for patients refractory to conventional or biologic therapies.
  • Generic tofacitinib offers a lower-cost alternative, particularly beneficial for low- to middle-income countries.
  • Key risks include infections (Herpes Zoster, tuberculosis), and contraindications exist for patients with venous thromboembolism or cardiovascular disease risk factors.

Conclusions:

  • Tofacitinib is a valuable treatment for ulcerative colitis, especially in resource-limited settings.
  • Careful patient selection is crucial, considering risks and contraindications.
  • Further research, including head-to-head trials with biologics and evaluation in acute severe colitis, is warranted.
Keywords:
Inflammatory bowel diseaseJAK inhibitorsJanus kinaseacute severe colitisherpes zostermajor adverse cardiovascular eventstuberculosisvenous thromboembolism

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