Dual therapy with tofacitinib and steroids for acute severe ulcerative colitis: a randomized double-blind placebo-controlled trial.

What To Know

This randomized, double-blind, placebo-controlled trial tested adding tofacitinib to intravenous corticosteroids for adults hospitalized with acute severe ulcerative colitis (ASUC). The trial was stopped early for slow recruitment and analyzed 58 patients.

Unadjusted day-6 treatment failure was numerically lower with tofacitinib but not statistically significant; after adjustment for a baseline serum albumin imbalance the reduction met statistical significance.

Over 90 days there was no difference in colectomy rates, but fewer patients on tofacitinib required rescue therapy and more stayed on assigned treatment. Practical points Because the study was single-center and stopped early, the results are preliminary and need confirmation in larger trials.

The trial reports fewer rescue treatments with tofacitinib but no reduction in colectomy at 90 days; safety events were few but small numbers limit conclusions. This report does not change standard care on its own but provides a signal that adding a JAK inhibitor early could reduce need for rescue therapy in ASUC that warrants further study.