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Treatment options for severe ulcerative colitis are limited. Once intravenous (IV) steroids have failed, the only medications left are cyclosporine and high-dose infliximab, but often patients have already been on anti–tumor necrosis factor (TNF) therapy. Now, researchers at one U.S. academic center describe outcomes of off-label use of the small-molecule oral compound tofacitinib in four hospitalized patients with acute severe ulcerative colitis (ASUC).
Patients received high-dose tofacitinib (10 mg three times daily for 9 doses) to try to prevent surgery. All four patients had improvement in their clinical symptoms and three went into clinical remission. No major adverse effects were reported in the short term nor after 18 months of follow…