Tofacitinib: New drug in the therapeutic armamentarium in ocular inflammation

Tofacitinib, an oral Janus kinase (JAK) inhibitor, has established efficacy in the management of several autoimmune and inflammatory disorders, including rheumatoid arthritis, psoriatic arthritis, dermatitis, and ulcerative colitis. By inhibiting JAK phosphorylation, tofacitinib modulates cytokine-mediated inflammatory responses through interference with the JAK-STAT signaling pathway. In recent years, accumulating real-world evidence from India has suggested a beneficial role for tofacitinib in the management of ocular inflammatory diseases, particularly in patients with refractory disease who have failed conventional disease-modifying antirheumatic drugs and biologic therapies. Factors such as oral administration, rapid clinical response, ease of monitoring, and relative affordability compared with biologics have facilitated its wider adoption in routine clinical practice in the Indian setting. This review discusses the drug tofacitinib, mode of action, safety profile, its utility in non-infectious uveitis and with a particular emphasis on real-world data and socioeconomic considerations relevant to resource-limited settings.