Taha Qazi, MD: Using Tofacitinib to Improve Treatment Response in Acute Severe Ulcerative Colitis

The latest issue of Qazi Corner, a collaborative quarterly newsletter on gastroenterology research, news, and trends between HCPLive and editor-in-chief Taha Qazi, MD, featured a review of a randomized controlled trial examining the impact of adding tofacitinib to corticosteroids on treatment responsiveness in patients with acute severe ulcerative colitis.

Although acute severe ulcerative colitis management is frequently characterized by the use of intravenous corticosteroids, many patients experience steroid refractoriness and will require surgery. Thus, options to increase treatment responsiveness in this patient population are essential for improving outcomes, and findings from a recent study suggest a combination of tofacitinib and corticosteroids may offer a potential solution.

Authored by Qazi’s colleague, Ravi Shah, MD, the piece examined tofacitinib’s role in acute severe ulcerative colitis management as a first-line therapy to add to the limited treatment options available for this patient population.

“I think this is an example of the data suggesting that tofacitinib may have a role in that JAK stat pathway and may have a role in the management of acute severe ulcerative colitis, which is something that I think is novel and new,” Qazi, a gastroenterologist with the Cleveland Clinic, said in an interview with HCPLive, describing tofacitinib as an example of a newer medication being repurposed to strategize severe cases of ulcerative colitis.

Given the study was conducted in India, Qazi was careful to note the practices outlined in the study do not align with standard practice in the US regarding management with steroid tapering. However, he referenced another recent study with data from European centers again looking at tofacitinib in the context of acute severe ulcerative colitis, which also showed a potential signal for response beyond standard paradigms using infliximab and steroids and/or cyclosporine and steroids

“Currently, I think I would still potentially use infliximab and cyclosporine for management in hospitalized patients, but in a select patient population who is able to get the medication and is deemed safe to get the medication, I think I would be willing to use the medication for management, especially if they've been exposed to an anti TNF or infliximab in the past,” said Qazi, who concluded that he looks forward to the use of this medication moving forward.

Read Shah's article from Qazi Corner Issue 5 here