Efficacy And Safety Of Low Dose Tofacitinib As Induction Therapy In Moderate To Severe Ulcerative Colitis: A Pilot Study

Objective: The Inflammatory cascade has been the root cause of ulcerative colitis's pathogenesis, and its treatment would centre upon reducing its intensity. Tofacitinib, an orally administered micromolecule, blocks the Janus kinase (JAK) signal transducer pathway, thereby reducing mucosal inflammation. This observational study aimed to assess Tofacitinib's efficacy in relieving Ulcerative Collitis symptoms. Methods: Out of 19 patients included in the study, only 09 completed the treatment as per inclusion criteria. The Patients were given 5mg of Tofacitinib daily for 6-8 weeks. Total Mayo score i.e. stool frequency, Rectal bleeding, Endoscopic findings and physician global assessment and Partial Mayo score i.e. Total Mayo score minus Endoscopic findings were used as a parameter for disease severity characterization and Partial Mayo score was used as a parameter for measuring the response after treatment. Results: Out of these patients, 05(50%) developed some sort of side effects prominently flatulence, abdominal discomfort, and generalized edema. Loss of coordination was observed in one 46-year-old male patient. The mean age of the patients presenting with UC was 43.4 years, with an average of 25.2 months of disease duration. The mean partial Mayo score improved from 5.40 to 2.90 after treatment with 5mg of Tofacitinib. The mean of the stool frequency improved significantly from 8.89 to 3.56. Conclusion: Low-dose Tofacitinib is an effective option in the treatment of moderate to severe ulcerative colitis offering efficacy comparable to biologics with lesser side effects, no loss of efficacy over time and cost-effectiveness Keywords: Ulcerative Colitis, Inflammation.