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Japanese pediatric patient with refractory steroid-resistant ulcerative colitis successfully treated with

Toshihiko Kakiuchi1, Masato Yoshiura

  • 1Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan.

Medicine
|November 18, 2022
PubMed

Insights

Tofacitinib successfully induced and maintained remission in a pediatric patient with moderately active ulcerative colitis (UC) refractory to other treatments. This case highlights tofacitinib as a safe and effective option for pediatric UC management.

Area of Science:

  • Pediatric gastroenterology
  • Immunomodulatory therapies
  • Inflammatory bowel disease research

Background:

  • Tofacitinib, a Janus kinase inhibitor, shows efficacy in adult ulcerative colitis (UC).
  • Limited data exists on tofacitinib's efficacy in pediatric UC patients.
  • Current treatment options for refractory pediatric UC are often limited.

Observation:

  • A 9-year-old boy presented with a 2-month history of diarrhea and bloody stools.
  • Colonoscopy confirmed total colitis-type UC with a pediatric UC activity index score of 40 (moderately active).
  • The patient was refractory to multiple biologic therapies including vedolizumab, golimumab, and ustekinumab.

Findings:

  • Tofacitinib 5 mg twice daily was administered for steroid-resistant UC.
  • The patient achieved and maintained clinical remission of UC without adverse events.
  • This represents the first reported pediatric case of tofacitinib-induced UC remission in Japan.

Implications:

  • Tofacitinib demonstrates safety and efficacy in pediatric patients with moderately active UC.
  • It offers a potential therapeutic option for steroid-dependent UC refractory to other biologics.
  • Lower-dose tofacitinib induction therapy may be sufficient, potentially reducing adverse events in children and adults.
Abstract

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