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Title: Sequential use of high-dose tofacitinib after infliximab salvage therapy in acute severe ulcerative colitis.
Austin Authors: Gilmore, Robert B ;Hilley, Patrick ;Srinivasan, Ashish ;Choy, Matthew C ;De Cruz, Peter P 
Affiliation: Gastroenterology and Hepatology
Medicine (University of Melbourne)
Issue Date: 2022
Date: 2021-06-22
Publication information: Journal of Crohn's & Colitis 2022; 16(1): 166-168
Abstract: Preliminary data regarding the effectiveness of tofacitinib in acute severe ulcerative colitis (ASUC) have been presented in two previous case series. We aimed to describe the novel use of high-dose tofacitinib immediately following non-response to infliximab in the setting of steroid-refractory acute severe ulcerative colitis (ASUC). Five patients who received high-dose tofacitinib 10mg three times a day immediately following non-response to infliximab for steroid-refractory ASUC were identified at an Australian tertiary inflammatory bowel disease centre. Four of 5 patients demonstrated clinical response to high-dose tofacitinib induction during their inpatient admission, with one patient requiring colectomy owing to a lack of clinical response. At 90 days, all four initial responders remained colectomy-free, with two patients achieving combined clinical and endoscopic remission. No adverse events directly attributable to high-dose tofacitinib were identified. High-dose tofacitinib may have a role as salvage therapy in the setting of steroid-refractory ASUC. Prospective studies are required to determine the safety and efficacy of high-dose tofacitinib to determine whether it can be routinely recommended as primary or sequential salvage therapy in the setting of steroid-refractory ASUC.
DOI: 10.1093/ecco-jcc/jjab109
ORCID: 0000-0001-5952-1570
Journal: Journal of Crohn's & Colitis
PubMed URL: 34159363
Type: Journal Article
Subjects: Acute Severe Ulcerative Colitis
Appears in Collections:Journal articles

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