New Study Highlights Tofacitinib as Effective Option for Refractory Ulcerative Colitis Patients

A recent French multicenter study comparing two treatments for ulcerative colitis (UC) found that tofacitinib (Xeljanz) may be a more effective option for patients who have failed multiple biologic therapies. The findings, published in Clinical Gastroenterology and Hepatology, suggest that tofacitinib could be a viable alternative for heavily pretreated patients.
The study evaluated 289 adults with UC across 10 French inflammatory bowel disease centers, comparing tofacitinib and ustekinumab (Stelara). Both treatments showed similar rates of corticosteroid-free symptomatic remission at week 16 (37.8% for tofacitinib vs. 35.8% for ustekinumab). However, in patients who had previously tried three or more advanced therapies, tofacitinib was associated with a significantly higher remission rate (46.7%) compared to ustekinumab (23.1%).
The study also found that baseline disease severity did not influence the efficacy of either drug. This suggests that tofacitinib may be a better option for patients with multiple prior treatment failures, regardless of disease severity.
Dr. Anthony Buisson, lead author of the study, noted that the findings could help guide personalized treatment approaches for UC patients. Tofacitinib, a Janus kinase (JAK) inhibitor, works by blocking intracellular signaling pathways involved in inflammation, which may make it less affected by prior exposure to biologic therapies compared to ustekinumab, an interleukin (IL)-12/23 inhibitor.
The study’s retrospective design and use of propensity score weighting helped balance baseline characteristics, though it had limitations, including the lack of central endoscopic or histologic reading. Despite these limitations, the study remains one of the largest to date, providing valuable insights into treatment options for refractory UC.
In conclusion, the findings suggest that tofacitinib may offer a more effective treatment option for UC patients with extensive prior treatment histories, potentially improving outcomes for this challenging patient population.

Published: 8/22/2025