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a meta-analysis, intravenous infliximab is preferentially recommended in acute severe UC. They did not differ from placebo in terms of the incidence of side effects and did not require combination treatment with immunomodulators. ofacitinib, all Janus kinase inhibitor, is the first small-molecule drug approved as a first-line treatment for UC. In the OC-TAVE 1 and OCTAVE 2 trials in patients with severe UC, tofacitinib 10 mg demonstrated more effective clinical remission than placebo (18.5% vs. 8.2%, P = 0.007 and 16.6% vs. 3.6%, P < 0.001, respectively). 9 Tofacitinib cannot be directly compared with other biologics in the absence of head-to-head trials in patients with UC. As a result of a meta-analysis, efficacy in first-line treatment was confirmed as similar to that of other biologics. However, in a recent study, tofacitinib was recommended as second-line or higher treatment when there was no response to other biologics. The main reason was safety concerns, such as serious cardiovascular events, cancer, and infections. In addition, tofacitinib is an ideal second-line treatment because, unlike biologics, the clinical response rate is similar in patients with and without biological experience.
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Jun Lee (2022) studied this question.
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