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IBD
Optimal use and cycling strategies of Janus kinase inhibitors in ulcerative colitis: current evidence and clinical implications from the KASID Guidelines Task Force Team
Seung Min Hong, Dong Hyun Kim, June Hwa Bae, Seung Yong Shin, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Seong-Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Miyoung Choi, Myung Ha Kim, Won Moon, Sung-Ae Jung, KASID Guidelines Taskforce Team of the Korean Association for the Study of Intestinal Diseases (KASID)
Intest Res 2026;24(1):27-37.   Published online January 28, 2026
DOI: https://doi.org/10.5217/ir.2025.00309
AbstractAbstract PDFPubReaderePub
Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.
  • 1,265 View
  • 69 Download
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The JAK attack: transforming the management of ulcerative colitis in India
Arshdeep Singh, Arshia Bhardwaj, Vandana Midha, Ajit Sood
Received July 26, 2025  Accepted September 8, 2025  Published online January 2, 2026  
DOI: https://doi.org/10.5217/ir.2025.00153    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
Inflammatory bowel disease is increasingly recognized as a significant clinical entity in India, reflecting the country’s ongoing epidemiological transition. With a rising incidence and an expanding disease spectrum, the limitations of conventional therapeutic agents, such as corticosteroids and thiopurines, have become increasingly evident. This review examines the transformative role of Janus kinase inhibitors, particularly tofacitinib, in redefining therapeutic goals and bridging the gap between medical innovation and real-world implementation in resource-limited settings. Tofacitinib represents a pivotal advancement in the therapeutic landscape of ulcerative colitis (UC) in India, offering the advantages of oral administration, rapid onset of action, predictable pharmacokinetics, and cost-effective generic formulations–thereby overcoming several longstanding barriers to the adoption of advanced therapies. Accumulating real-world evidence from India supports its clinical utility across various phenotypes of UC, including corticosteroid-dependent or refractory disease, acute severe UC, ulcerative proctitis, elderly-onset UC, and in achieving deeper remission endpoints such as histologic healing. Furthermore, its incorporation into routine clinical practice has contributed to a measurable reduction in corticosteroid reliance, thereby aligning treatment strategies with international standards of care. By combining efficacy, safety, accessibility, and ease of use, tofacitinib has catalyzed a paradigm shift in the management of UC in the Indian context.
  • 1,140 View
  • 141 Download
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Optimizing Janus kinase inhibitor therapy for ulcerative colitis: a real-world perspective
Shintaro Akiyama
Received June 1, 2025  Accepted June 19, 2025  Published online November 14, 2025  
DOI: https://doi.org/10.5217/ir.2025.00096    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
In real-world clinical practice, 3 Janus kinase (JAK) inhibitors—tofacitinib, filgotinib, and upadacitinib—are now available for the treatment of ulcerative colitis. Emerging real-world evidence highlights distinct efficacy and safety profiles among these agents, largely attributed to differences in JAK selectivity and dosing strategies. Notably, data are accumulating on differential efficacy, predictors of therapeutic response, and outcomes in patients who switch between JAK inhibitors, contributing to a clearer understanding of the optimal positioning of each agent. Regarding safety, particular attention has been given to risks such as herpes zoster infection and drug-induced acne, underscoring the importance of appropriate patient education and individualized risk assessment. This review summarizes clinical trials and current real-world data on tofacitinib, filgotinib, and upadacitinib in ulcerative colitis, and discusses strategies for optimizing their clinical application.
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  • 236 Download
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Original Articles
Post-marketing surveillance of tofacitinib in patients with ulcerative colitis in Japan: a post hoc analysis of safety and effectiveness in older (≥65 years) and younger (<65 years) patients
Katsuyoshi Matsuoka, Takayuki Yamamoto, Minoru Matsuura, Toshimitsu Fujii, Shoko Arai, Yutaka Endo, Keiko Sato, Hirotoshi Yuasa, Yasushi Mizuno, Yuki Kobayashi, Tadakazu Hisamatsu
Received April 16, 2025  Accepted July 14, 2025  Published online November 10, 2025  
DOI: https://doi.org/10.5217/ir.2025.00058    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
To assess, post hoc, tofacitinib safety/effectiveness in patients with ulcerative colitis (UC), stratified by age, using data from a 60-week post-marketing surveillance (PMS) study in Japan.
Methods
All patients with UC receiving tofacitinib in Japan were enrolled in a large PMS study. Incidence proportions of adverse events (AEs), incidence rates (IRs; unique patients with events/100 patient-years of exposure) of clinically important AEs, reasons for discontinuation, and partial Mayo score clinical remission, stratified by age ( ≥ 65 and < 65 years), were evaluated.
Results
The analysis included 212 older ( ≥ 65 years) and 1,770 younger ( < 65 years) patients. Demographics and baseline disease characteristics were generally similar between groups; however, more older versus younger patients had cardiovascular disease (23.1% vs. 4.6%). Incidence proportions of AEs were comparable between groups, but IRs (95% confidence intervals) in older versus younger patients were numerically higher for herpes zoster (9.81 [5.72–15.71] vs. 5.44 [4.28–6.82]), and higher for serious infections (4.45 [1.92–8.76] vs. 1.14 [0.65–1.85]). More older versus younger patients discontinued due to AEs (28.6% vs. 17.6%); more younger versus older patients discontinued due to insufficient clinical responses (50.3% vs. 35.2%). Clinical remission rates through 60 weeks were generally similar between groups.
Conclusions
Older patients had higher IRs of herpes zoster and serious infection than younger patients, although tofacitinib effectiveness was similar between age groups. Discontinuation due to AEs was more common in older patients. Despite the smaller sample size of older versus younger patients, a focused evaluation of older patients is of benefit.
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  • 172 Download
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IBD
Comparative short-term efficacy of upadacitinib versus tofacitinib for ulcerative colitis: a 24-week real-world study in Japan
Akiko Tamura, Hiromichi Shimizu, Toshimitsu Fujii, Ami Kawamoto, Ryo Morikawa, Shuji Hibiya, Kento Takenaka, Masakazu Nagahori, Kazuo Ohtsuka, Ryuichi Okamoto
Intest Res 2026;24(1):95-102.   Published online March 20, 2025
DOI: https://doi.org/10.5217/ir.2024.00187
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Tofacitinib and upadacitinib are small-molecule compounds that inhibit the Janus kinase pathway for the treatment of refractory ulcerative colitis. Only a few reports have compared the efficacy and safety of these 2 drugs in real-world practice. We aimed to show our real-world evidence of these drugs and compare the efficacy and safety profiles in the treatment of ulcerative colitis.
Methods
This study is a single-center retrospective analysis. Patients treated with tofacitinib or upadacitinib at our hospital between June 2018 and January 2024 who were monitored for 24 weeks were included. The primary outcome was steroid-free clinical remission at 24 weeks. Secondary outcomes were response and remission rates at each time point, time series changes in partial Mayo scores and laboratory results, treatment survival at 24 weeks, and the incidence of adverse events.
Results
A total of 68 patients treated with tofacitinib and 34 patients treated with upadacitinib were included. Steroid-free clinical remission rate at 24 weeks was significantly higher in upadacitinib-treated patients than in tofacitinibtreated patients (64.7% vs. 38.2%). The response rates in upadacitinib-treated patients exceeded 60% after 8 weeks of treatment through to 24 weeks, and the rates were higher than those in tofacitinib-treated patients. The incidences of adverse events were 79.4% in upadacitinib-treated patients and 38.2% in tofacitinib-treated patients. The most common adverse event was acne for upadacitinib.
Conclusions
Upadacitinib was more effective than tofacitinib in inducing remission in ulcerative colitis patients. The incidence of adverse events was significantly higher with upadacitinib than tofacitinib.

Citations

Citations to this article as recorded by  
  • Optimal use and cycling strategies of Janus kinase inhibitors in ulcerative colitis: current evidence and clinical implications from the KASID Guidelines Task Force Team
    Seung Min Hong, Dong Hyun Kim, June Hwa Bae, Seung Yong Shin, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Seong-Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Miyoung Choi, Myung Ha
    Intestinal Research.2026; 24(1): 27.     CrossRef
  • Incidence of acne in patients with inflammatory bowel disease treated with Janus kinase inhibitors: a systematic review and meta-analysis
    Mohammed Nabil Quraishi, Maryam A Alahmad, Thaer Khaleel Swaid, Antonio Facciorusso, Alyssa A Grimshaw, Badr Al-Bawardy
    Inflammatory Bowel Diseases.2026;[Epub]     CrossRef
  • Upadacitinib after tofacitinib in ulcerative colitis
    Hyeon Jin Cho, Eun Soo Kim
    Intestinal Research.2025; 23(3): 229.     CrossRef
  • Comparative effectiveness and safety of tofacitinib and filgotinib in patients with ulcerative colitis: A propensity score-weighted cohort study
    Fabio Salvatore Macaluso, Walter Fries, Anna Viola, Clara De Francesco, Nunzio Belluardo, Emiliano Giangreco, Maria Cappello, Roberto Ajovalasit, Filippo Mocciaro, Barbara Scrivo, Antonino Carlo Privitera, Maria Emanuela Distefano, Alessandro Vitello, Con
    Digestive and Liver Disease.2025; 57(11): 2109.     CrossRef
  • Tofacitinib in acute severe ulcerative colitis: review addressing seven key unmet needs
    Chuong Dinh Nguyen, Luan Minh Dang, Thong Duy Vo, Hoang Huu Bui, Eun Soo Kim, Joyce Wing Yan Mak, Choon Jin Ooi
    Therapeutic Advances in Gastroenterology.2025;[Epub]     CrossRef
  • Successful treatment of tofacitinib-refractory scleritis associated with multiple systemic inflammatory diseases using upadacitinib
    Kodai Yuge, Nobuyo Yawata, Kenichiro Asahara, Satoshi Yamana, Nobuyuki Ono, Koh-Hei Sonoda
    Immunological Medicine.2025; : 1.     CrossRef
  • Optimizing Janus kinase inhibitor therapy for ulcerative colitis: a real-world perspective
    Shintaro Akiyama
    Intestinal Research.2025;[Epub]     CrossRef
  • Janus Kinase Inhibitors for Inflammatory Bowel Disease: Concise Questions and Answers on Their Use in Clinical Practice
    Javier P Gisbert, María Chaparro
    Inflammatory Bowel Diseases.2025;[Epub]     CrossRef
  • Upadacitinib versus Tofacitinib in the Management of Ulcerative Colitis: A Systematic Review and Meta-Analysis
    Tareq Alsaleh, Abdul Mohammed, Aimen Farooq, Magda Elamin, Amr Akl, Karim Mohamed Yassin, Ahmed Elnaggar, Jennifer Seminerio
    Inflammatory Intestinal Diseases.2025; 11(1): 29.     CrossRef
  • 8,392 View
  • 566 Download
  • 8 Web of Science
  • 9 Crossref
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IBD
Propensity score-matched real-world comparative treatment outcomes of Janus kinase inhibitors for ulcerative colitis in patients with and without prior exposure to anti-tumor necrosis factor α antibody
Maiko Ikenouchi, Hirokazu Fukui, Soichi Yagi, Akira Nogami, Koji Kaku, Toshiyuki Sato, Mikio Kawai, Koji Kamikozuru, Yoko Yokoyama, Tetsuya Takagawa, Toshihiko Tomita, Taku Kobayashi, Shinichiro Shinzaki
Intest Res 2025;23(4):464-474.   Published online February 3, 2025
DOI: https://doi.org/10.5217/ir.2024.00148
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Tofacitinib (TFB), filgotinib (FIL), and upadacitinib (UPA) are Janus kinase (JAK) inhibitors approved for moderate-to-severe ulcerative colitis (UC). The appropriate positioning of each JAK inhibitor in the treatment algorithm, however, is unclear. Furthermore, real-world efficacy of JAK inhibitors for patients with UC and prior anti-tumor necrosis factor α antibody (aTNF) treatment are not fully investigated. We compared the efficacy and safety of 3 JAK inhibitors in patients with UC, considering their prior aTNF exposure.
Methods
A retrospective study was conducted in patients with UC who started TFB, FIL, or UPA at 2 academic centers. This propensity score-matched cohort study assessed the effectiveness of the 3 JAK inhibitors for UC in patients with and without prior aTNF exposure, comparing steroid-free clinical remission and response rates after 8 weeks.
Results
Among 274 patients who met the inclusion criteria, 145 experienced aTNF exposure (TFB: 59.2%, 100/169; FIL: 34.5%, 20/58; UPA: 53.2%, 25/47). Based on propensity score-matching, UPA led to a higher steroid-free clinical remission rates than TFB (adjusted odds ratio [aOR], 5.57; 95% confidence interval [CI], 1.42–21.90) or FIL (aOR, 9.00; 95% CI, 1.42–57.10) in patients exposed to aTNF. Steroid-free clinical remission and clinical response rates did not differ significantly between each group in patients non-exposed to aTNF. The incidence of adverse events was slightly higher with UPA than TFB or FIL.
Conclusions
UPA may be more effective for UC than TFB or FIL, especially in patients with previous aTNF exposure, although consideration should be given to adverse events.

Citations

Citations to this article as recorded by  
  • Long-term clinical outcomes with filgotinib in ulcerative colitis: 12-month results from the FILGUITO study
    Antonio M Caballero-Mateos, Claudio Trigo-Salado, Álvaro Suárez-Toribio, María del Mar Martín-Rodríguez, Francisco J Rodríguez-González, Teresa Valdés-Delgado, Héctor Pallarés-Manrique, Ana María Trapero-Martínez, Raúl Olmedo-Martín, Cristina Bailón-Gaona
    World Journal of Gastroenterology.2026;[Epub]     CrossRef
  • Optimal use and cycling strategies of Janus kinase inhibitors in ulcerative colitis: current evidence and clinical implications from the KASID Guidelines Task Force Team
    Seung Min Hong, Dong Hyun Kim, June Hwa Bae, Seung Yong Shin, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Seong-Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Miyoung Choi, Myung Ha
    Intestinal Research.2026; 24(1): 27.     CrossRef
  • The Evolving Landscape of Advanced Therapies in Inflammatory Bowel Disease: Current Evidence and Emerging Targets
    Daniele Balducci, Marta Mosca, Sabrina Monaco, Susanna Faenza, Stefano Fabiani, Fabio Cortellini, Nicola Cesaro, Gianpiero Stefanelli, Salvatore Paba, Maddalena Pecchini, Michele Montori, Marco Valvano
    Gastrointestinal Disorders.2026; 8(1): 13.     CrossRef
  • Incidence of acne in patients with inflammatory bowel disease treated with Janus kinase inhibitors: a systematic review and meta-analysis
    Mohammed Nabil Quraishi, Maryam A Alahmad, Thaer Khaleel Swaid, Antonio Facciorusso, Alyssa A Grimshaw, Badr Al-Bawardy
    Inflammatory Bowel Diseases.2026;[Epub]     CrossRef
  • Comparative effectiveness and safety of tofacitinib and filgotinib in patients with ulcerative colitis: A propensity score-weighted cohort study
    Fabio Salvatore Macaluso, Walter Fries, Anna Viola, Clara De Francesco, Nunzio Belluardo, Emiliano Giangreco, Maria Cappello, Roberto Ajovalasit, Filippo Mocciaro, Barbara Scrivo, Antonino Carlo Privitera, Maria Emanuela Distefano, Alessandro Vitello, Con
    Digestive and Liver Disease.2025; 57(11): 2109.     CrossRef
  • Three Janus kinase inhibitors in ulcerative colitis: is upadacitinib taking the lead?
    Yoon Suk Jung
    Intestinal Research.2025; 23(4): 394.     CrossRef
  • Optimizing Janus kinase inhibitor therapy for ulcerative colitis: a real-world perspective
    Shintaro Akiyama
    Intestinal Research.2025;[Epub]     CrossRef
  • Janus Kinase Inhibitors for Inflammatory Bowel Disease: Concise Questions and Answers on Their Use in Clinical Practice
    Javier P Gisbert, María Chaparro
    Inflammatory Bowel Diseases.2025;[Epub]     CrossRef
  • Upadacitinib versus Tofacitinib in the Management of Ulcerative Colitis: A Systematic Review and Meta-Analysis
    Tareq Alsaleh, Abdul Mohammed, Aimen Farooq, Magda Elamin, Amr Akl, Karim Mohamed Yassin, Ahmed Elnaggar, Jennifer Seminerio
    Inflammatory Intestinal Diseases.2025; 11(1): 29.     CrossRef
  • 8,422 View
  • 582 Download
  • 7 Web of Science
  • 9 Crossref
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IBD
Upadacitinib induction is effective and safe in ulcerative colitis patients including those with prior exposure to tofacitinib: a multicenter real-world cohort study
Robert Gilmore, Richard Fernandes, Imogen Hartley, Arteen Arzivian, Rupert Leong, Bridgette Andrew, Abhinav Vasudevan, Tessa Greeve, Gregory Thomas Moore, Steven Kim, Daniel Lightowler, Abhey Singh, Gillian Mahy, Aditya Mithanthaya, Kannan Venugopaul, Sangwoo Han, Robert Bryant, Jack West, Jonathan Segal, Britt Christensen, Crispin Corte, Nik Ding, Yoon-Kyo An, Jakob Begun
Intest Res 2025;23(3):347-357.   Published online December 20, 2024
DOI: https://doi.org/10.5217/ir.2024.00127
AbstractAbstract PDFPubReaderePub
Background/Aims
Upadacitinib is a novel selective Janus kinase inhibitor approved for use in ulcerative colitis. Clinical trials had rigorous criteria and excluded many patient subgroups. Given limited real-world effectiveness data, we examined outcomes of patients treated with upadacitinib for ulcerative colitis in a real-world population.
Methods
Patients that commenced upadacitinib for moderate-to-severe ulcerative colitis from September 2022 until March 2023 were identified at 13 inflammatory bowel disease centers across Australia. Clinical, biochemical, endoscopic, and intestinal ultrasound outcomes were recorded retrospectively at baseline, week 8, and week 16.
Results
One hundred and fifty-two patients (61 female [40%], median age 38 years [interquartile range, 28–50]) were included. The primary endpoint of clinical remission was met in 79% at week 8, and 84% at week 16. A total of 42 patients (28%) with prior tofacitinib exposure were included. No significant difference in clinical remission was observed by week 16 between tofacitinib experienced compared to tofacitinib naïve patients (86% vs. 84%, P= 0.67). Complete intestinal ultrasound data was available for 36 patients, showing transmural remission in 64% at week 8 and 81% at week 16, with a decrease in median bowel wall thickness of 2.3 mm and 2.4 mm, respectively.
Conclusions
Upadacitinib resulted in high rates of clinical remission at 8 and 16 weeks in this large real-world cohort of ulcerative colitis patients. Upadacitinib is effective in patients with prior tofacitinib exposure. Intestinal ultrasound shows significant rates of transmural remission at week 8, sustained through week 16.

Citations

Citations to this article as recorded by  
  • Letter: Toward Intra‐Class Switching With JAK Inhibitors?
    Mathieu Uzzan, David Laharie
    Alimentary Pharmacology & Therapeutics.2025; 61(5): 919.     CrossRef
  • Effectiveness and Safety of a Second JAK Inhibitor in Ulcerative Colitis: The J2J Multicentre Study
    Mathilde Osty, Romain Altwegg, Mélanie Serrero, Alban Benezech, Albane Lecomte, Guillaume Cadiot, Lucine Vuitton, Anne Wampach, Stéphane Nancey, Anthony Buisson, Catherine le Berre, Clea Rouillon, Cyrielle Gilletta, Felix Goutorbe, Mathurin Fumery, Nassim
    Alimentary Pharmacology & Therapeutics.2025; 62(4): 430.     CrossRef
  • Upadacitinib and vedolizumab combination therapy for the management of refractory ulcerative colitis and Crohn’s disease
    Robert Gilmore, Amrutha Murali, Amirah Etchegaray, Ei Swe, Yoon-Kyo An, Jakob Begun
    Intestinal Research.2025; 23(4): 475.     CrossRef
  • Upadacitinib after tofacitinib in ulcerative colitis
    Hyeon Jin Cho, Eun Soo Kim
    Intestinal Research.2025; 23(3): 229.     CrossRef
  • A Comparison of the Efficacy and Safety of Ustekinumab and Upadacitinib in Biologically Experienced Ulcerative Colitis Patients
    Osman Özdoğan, Serkan Yaraş, Mehmet Kasım Aydın, Fehmi Ateş, Engin Altıntaş, Orhan Sezgin
    Biomedicines.2025; 13(10): 2455.     CrossRef
  • Is 2nd JAKi treatment for UC worth the effort? A retrospective, multi-centre UK study
    Chandni Radia, Yaa Danso, Susan Ritchie, Melissa Hale, Alexander T Elford, Chirag Patel, Lucy Hicks, Sonia Kalyanji, Chaonan Dong, Katie Yeung, Jie Han Yeo, Mohammed Allah-Ditta, Maria Bishara, Karishma Sethi-Arora, Lushen Pillay, Emma L Johnston, Ruth Ru
    Journal of Crohn's and Colitis.2025;[Epub]     CrossRef
  • IBD 2024: Charting a New Course in IBD Proceedings of the Takeda Symposium 22–23 November 2024 W Hotel, Brisbane, Queensland, Australia
    Uma Mahadevan, Vipul Jairath, Jakob Begun, Aviv Pudipeddi, Mayur Garg, Peter De Cruz, Christopher F. D. Li Wai Suen, Matthew C. Choy, Danny Con, Rose Vaughan, John D. Chetwood, David A. Clark, Craig Haifer, Miles P. Sparrow, Rupert Leong, Réme Mountifield
    Journal of Gastroenterology and Hepatology.2025; 40(S3): 3.     CrossRef
  • Three Janus kinase inhibitors in ulcerative colitis: is upadacitinib taking the lead?
    Yoon Suk Jung
    Intestinal Research.2025; 23(4): 394.     CrossRef
  • Upadacitinib’s Effectiveness and Safety as a Second- or Third-Line Therapy in Patients with Ulcerative Colitis: Data from a Real-World Study
    Giammarco Mocci, Antonio Tursi, Franco Scaldaferri, Daniele Napolitano, Daniela Pugliese, Giovanni Maconi, Giovanni Cataletti, Roberta Pica, Claudio Cassieri, Edoardo Vincenzo Savarino, Caterina De Barba, Francesco Costa, Linda Ceccarelli, Manuela Marzo,
    Journal of Clinical Medicine.2025; 14(21): 7801.     CrossRef
  • Optimizing Janus kinase inhibitor therapy for ulcerative colitis: a real-world perspective
    Shintaro Akiyama
    Intestinal Research.2025;[Epub]     CrossRef
  • Janus Kinase Inhibitors for Inflammatory Bowel Disease: Concise Questions and Answers on Their Use in Clinical Practice
    Javier P Gisbert, María Chaparro
    Inflammatory Bowel Diseases.2025;[Epub]     CrossRef
  • 8,560 View
  • 422 Download
  • 13 Web of Science
  • 11 Crossref
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IBD
Long-term efficacy and safety of tofacitinib in patients with ulcerative colitis: 3-year results from a real-world study
Hiromichi Shimizu, Yuko Aonuma, Shuji Hibiya, Ami Kawamoto, Kento Takenaka, Toshimitsu Fujii, Eiko Saito, Masakazu Nagahori, Kazuo Ohtsuka, Ryuichi Okamoto
Intest Res 2024;22(3):369-377.   Published online July 16, 2024
DOI: https://doi.org/10.5217/ir.2023.00194
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The efficacy and safety of tofacitinib for the treatment of refractory ulcerative colitis (UC) has been demonstrated in clinical trials. Although, a series of reports with real-world evidence of its short-term efficacy and safety profiles have already been published, reports of long-term real-world data have been limited. We aimed to show our 3-year evidence on the clinical use of tofacitinib for the treatment of UC, focusing on its efficacy and safety profiles.
Methods
A retrospective observational study was conducted on patients who started tofacitinib for active refractory UC at our hospital. The primary outcome was the retention rate until 156 weeks after initiating tofacitinib. The secondary outcomes were short-term efficacy at 4, 8, and 12 weeks; long-term efficacy at 52, 104, and 156 weeks; prognostic factors related to the cumulative retention rate; loss of response; and safety profile, including adverse events.
Results
Forty-six patients who were able to be monitored for up to 156 weeks after tofacitinib initiation, were enrolled in this study. Continuation of tofacitinib was possible until 156 weeks in 54.3%, with > 50% response rates and > 40% remission rates. Among patients in whom response or remission was achieved and tofacitinib was deescalated after 8 weeks of induction treatment, 54.3% experienced relapse but were successfully rescued by and retained on reinduction treatment, except for 1 patient. No serious AEs were observed in the study.
Conclusions
Tofacitinib is effective and safe as long-term treatment in a refractory cohort of UC patients in real-world clinical practice.

Citations

Citations to this article as recorded by  
  • Comparative short-term efficacy of upadacitinib versus tofacitinib for ulcerative colitis: a 24-week real-world study in Japan
    Akiko Tamura, Hiromichi Shimizu, Toshimitsu Fujii, Ami Kawamoto, Ryo Morikawa, Shuji Hibiya, Kento Takenaka, Masakazu Nagahori, Kazuo Ohtsuka, Ryuichi Okamoto
    Intestinal Research.2026; 24(1): 95.     CrossRef
  • Optimal use and cycling strategies of Janus kinase inhibitors in ulcerative colitis: current evidence and clinical implications from the KASID Guidelines Task Force Team
    Seung Min Hong, Dong Hyun Kim, June Hwa Bae, Seung Yong Shin, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Seong-Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Miyoung Choi, Myung Ha
    Intestinal Research.2026; 24(1): 27.     CrossRef
  • The Evolving Landscape of Advanced Therapies in Inflammatory Bowel Disease: Current Evidence and Emerging Targets
    Daniele Balducci, Marta Mosca, Sabrina Monaco, Susanna Faenza, Stefano Fabiani, Fabio Cortellini, Nicola Cesaro, Gianpiero Stefanelli, Salvatore Paba, Maddalena Pecchini, Michele Montori, Marco Valvano
    Gastrointestinal Disorders.2026; 8(1): 13.     CrossRef
  • In which patients with ulcerative colitis would filgotinib be effective?
    Jihye Park
    Intestinal Research.2025; 23(1): 1.     CrossRef
  • Tofacitinib for ulcerative colitis in Brazil: a multicenter observational study on effectiveness and safety
    Rogério Serafim Parra, Renata de Sá Brito Fróes, Daniela Oliveira Magro, Sandro da Costa Ferreira, Munique Kurtz de Mello, Matheus Freitas Cardoso de Azevedo, Aderson Omar Mourão Cintra Damião, Alexandre de Sousa Carlos, Luísa Leite Barros, Maria Luiza Qu
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • State-of-the-Art Evidence for Clinical Outcomes and Therapeutic Implications of Janus Kinase Inhibitors in Moderate-to-Severe Ulcerative Colitis: A Narrative Review
    Yunseok Choi, Suhyun Lee, Hyeon Ji Kim, Taemin Park, Won Gun Kwack, Seungwon Yang, Eun Kyoung Chung
    Pharmaceuticals.2025; 18(5): 740.     CrossRef
  • Endo-histologic outcomes in patients with ulcerative colitis responding to tofacitinib
    Arshdeep Singh, Arshia Bhardwaj, Devanshi Jain, Riya Sharma, Dharmatma Singh, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Manavjot Singh, Pritish Gupta, Tanisha Sehgal, Vandana Midha, Ajit Sood
    Indian Journal of Gastroenterology.2025;[Epub]     CrossRef
  • Exploring the Factors Associated With the Discontinuation of Tofacitinib in Patients With Rheumatoid Arthritis: A Retrospective Cohort Study
    Li‐Huei Chiang, Chia‐Ling Yu, Tzu‐Cheng Tsai, Yao‐Fan Fang
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Review
IBD
Current new challenges in the management of ulcerative colitis
Tomohiro Fukuda, Makoto Naganuma, Takanori Kanai
Intest Res 2019;17(1):36-44.   Published online January 25, 2019
DOI: https://doi.org/10.5217/ir.2018.00126
AbstractAbstract PDFPubReaderePub
Ulcerative colitis (UC) is a chronic inflammatory condition of the gastrointestinal tract. Although the cause of UC is postulated to be multifactorial in nature, including genetic predisposition, epithelial barrier defects, dysregulation of immune responses, and environmental factors, the specific pathogenesis of UC is still incompletely understood. In the treatment of UC so far, a method of suppressing immunity and treating it has been mainstream. Immunosuppressant drugs, including thiopurines (azathioprine or 6-mercaptopurine), anti-tumor necrosis factor-α (anti-TNF-α) antibody (infliximab and adalimumab), and calcineurin inhibitor, can be used in treat patients with corticosteroid-dependent and/or corticosteroid-refractory moderateto- severe UC. Recently, in addition to such a conventional therapeutic agent, golimumab, which is the first transgenic human monoclonal anti-TNF-α antibody to be fabricated, anti α-4/β-7 integrin antibody, and Janus kinase inhibitor have been reported to novel immunosuppressant therapy. Furthermore, other treatments with unique mechanisms different from immunosuppression, have also been suggested, including fecal microbiota transplantation and Indigo naturalis, which is a Chinese herbal medicine. We compared the features and efficacy of these new treatments. In this issue, the features and treatment options for these new treatments is reviewed.

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