A retrospective cohort study from Banaras Hindu University evaluated tofacitinib as rescue therapy in 10 patients with steroid-refractory acute severe ulcerative colitis (ASUC) who were unable to receive infliximab due to cost or contraindications. Patients received high-intensity induction therapy (10 mg three times daily for 3 days, followed by 10 mg twice daily). Seven patients (70%) achieved clinical response within 5–7 days, with improvements in stool frequency, rectal bleeding, and inflammatory markers, while three patients required alternative rescue therapy or colectomy referral.
The study also identified high colonic cytomegalovirus (CMV) DNA burden (>50,000 copies/mL) as a potential predictor of treatment failure, with no response observed despite concurrent antiviral therapy. In contrast, patients with low or undetectable CMV burden demonstrated markedly better outcomes.…
