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Guideline review
Guideline review: Tofacitinib for adults with moderately to severely active ulcerative colitis - NICE guidance
  1. Akudo Nwaogu1,
  2. Ashley Bond2,
  3. Philip J Smith2
  1. 1Department of Medicine, Royal London Hospital, Barts Health NHS Trust, London, London, UK
  2. 2Department of Gastroenterology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
  1. Correspondence to Dr Philip J Smith, Department of Gastroenterology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, L7 8XP, UK; Philip.Smith{at}liverpoolft.nhs.uk

Abstract

Tofacitinib is an oral, Janus kinase (JAK) molecule, which selectively inhibits Janus-associated tyrosine kinases JAK1 and JAK3. It has already shown efficacy in the treatment of rheumatoid arthritis and the prevention of organ allograft rejection in kidney transplantation. Two separate phase III placebo-controlled trials, assessing 8-week efficacy of tofacitinib induction for ulcerative colitis (UC), demonstrated superiority when compared with placebo. Tofacitinib also demonstrated robust efficacy versus placebo in the 52-week maintenance component of the same study. Tofacitinib has been recommended by the National Institute for Health and Care Excellence as an effective treatment option for adult patients with moderate to severe UC when conventional therapy or a biological agent cannot be tolerated or the disease has responded inadequately or lost response to treatment. We review the guidelines and provide brief commentary on the post hoc analysis related to lipid increases and thromboembolism risk, which have lead to changes in current therapeutic guidance.

  • ulcerative colitis
  • inflammatory bowel disease
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Footnotes

  • Twitter @DrPhilipJSmith

  • Contributors AN, AB and PJS prepared the manuscript. AN and PJS prepared the tables and figures. All authors reviewed and approved the manuscript before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests PJS is an Associate Editor of Frontline Gastroenterology and the Digital and Education Editor of Gut.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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