Patients with ulcerative colitis at high risk of pulmonary embolism should not start treatment with tofacitinib. Patients who are already being treated with the 10 mg twice-daily dose of tofacitinib who are at high risk of pulmonary embolism should be switched to alternative treatments.
Patients at high risk of PE include those with cardiac failure, cancer, inherited blood clotting disorders/history of blood clots, patients taking combined hormonal contraceptives/HRT or those undergoing major surgery. In addition, clinicians should consider other factors that may increase the risk of PE including age, obesity, smoking or immobilisation.
Updated guidance will be available once the review is concluded.