Treatment with tofacitinib is effective and associated with sustained steroid-free remission in patients with UC, with the lowest effective dose recommended for maintenance therapy. However, there are limited real-world data to guide decisions on the optimal maintenance regimen.
Among 162 patients , 52% continued taking tofacitinib 10 mg twice a day and 48% underwent dose de-escalation to 5 mg twice a day. Among those who underwent dose de-escalation, over half experienced a UC event within 12 months. The cumulative 12-month event rate was 58% in those who did not de-escalate therapy.
Beck and colleagues note that, while"dose de-escalation is preferable for long-term maintenance therapy to reduce potential lifetime risk of medication-related adverse events, it must be balanced with sustained remission to prevent short- and long-term disease-related complications."