Tofacitinib in the treatment of ulceral colitis: real-world clinical practice and prospects

Ulcerative colitis is an immune-inflammatory disease characterized by ulcerative-destructive processes in the colon mucosa. Cytokines, proteins secreted by activated immune cells that affect the activity, differentiation, or proliferation of other cells, play a key role in pathogenesis. Improving the effectiveness of drug therapy for ulcerative colitis is currently associated with the addition of genetically engineered biological drugs (GEBD) and targeted immunosuppressants, Janus kinase inhibitors (tofacitinib), to traditional therapy. Compared with GEBD, tofacitinib has a number of advantages, including its oral administration, rapid onset of action, rapid elimination, and lack of immunogenicity. Tofacitinib was approved by the FDA in 2012 for the treatment of rheumatoid arthritis and in 2017 for the treatment of psoriatic arthritis, and in May 2018 for the treatment of ulcerative colitis. Currently, tofacitinib occupies an important place in the Federal Clinical Guidelines for Ulcerative Colitis of 2024. The Pubmed and Scopus databases were searched for articles on the use of tofacitinib in ulcerative colitis published in the current decade, with an emphasis on publications of the last year and publications not included in previously published domestic reviews. The studies found confirm the effectiveness of tofacitinib in the treatment of moderate to severe ulcerative colitis in patients in various geographic regions. A number of studies have noted the pharmacoeconomic effectiveness of tofacitinib compared to GEBD. Tofacitinib is not presented in the current clinical guidelines for ulcerative colitis for children, but a number of studies indicate the prospects for its integration into pediatric protocols.