email article Treatment with tofacitinib (Xeljanz) proved to be rapidly effective for moderate-to-severe ulcerative colitis (UC), even in patients who previously failed tumor necrosis factor (TNF) inhibition, post hoc analysis of trial data indicated. While the oral small-molecule JAK inhibitor had greater efficacy than placebo for both induction and maintenance of remission, rates of herpes zoster (serious and non-serious) were numerically higher in tofacitinib recipients, regardless of previous response to TNF inhibition, reported William Sandborn, MD, of the University of California San Diego. TNF inhibitor failure has been suggested as a predictor of poor prognosis in UC. Patients refractory to this therapy may be more challenging to treat, and therefore have an unmet need for alternative therapies.