Tofacitinib might be used in the treatment of ulcerative colitis

A phase 2 trial shows that an existing drug used to treat rheumatoid arthritis also has therapeutic effect on ulcerative colitis (UC), a common form of inflammatory bowel disease.

The study “Tofacitinib, an Oral Janus Kinase Inhibitor, in Active Ulcerative Colitis” is published online in the journal New England Journal of Medicine.

UC primarily affects the colon. The disease is curable by surgical removal of the colon, but it may involve a procedure called ileoanal anastomosis or a permanent opening in the abdomen.

The disease is characterized by a continuous inflammation of the mucosa. Patients with UC may experience abdominal pain, diarrhea, rectal bleeding, fatigue, weight loss, fever, and anemia. They may receive mesalamine, glucocorticoids, azathioprine, and anti-TNF agents such as infliximab and adalimumab to control their symptoms. However, these treatments are not universally effective. Novel therapies are in urgent need.

One potential therapy is tofacitinib, an oral inhibitor of the JAK family of kinases. The JAK kinases impact signaling involving multiple cytokines including IL-2, 4, 7, 9, 15, and 21. These cytokines are crucial for lymphocyte activation, function, and proliferation. Tofacitinib, marketed as Xeljanz and Jakvinus, is already used in the treatment of rheumatoid arthritis. In addition, this drug has also shown efficacy for prevention of organ allograft rejection. (Cusabio offers JAK, IL related proteins and antibodies. PODXL Monoclonal Antibody)

Now a study led by University of California San Diego, University of Calgary, Hospital Clinic de Barcelona, and Pfizer shows that tofacitinib gives relief to patients with moderate to severe UC who do not benefit from conventional treatments. University of California San Diego, University of Calgary, Hospital Clinic de Barcelona, and Pfizer participated in the study

The study enrolled a total of 194 adults with moderately to severely active UC, in most of whom conventional treatments had failed. These patients were randomly assigned to receive different doses of tofacitinib or placebo. Patients in the tofacitinib group had a better clinical response and clinical remission after treatment compared with patients in the placebo group. The most commonly reported adverse events related to infection were influenza and nasopharyngitis.

This phase 2 trial demonstrates the therapeutic effects of tofacitinib in the treatment of moderate to severe UC. The findings highlights that tofacitinib might be an additional therapeutic for UC.