A study to assess the efficacy of tofacitinib for the treatment of chronic pouchitis in adults

Some people with ulcerative colitis undergo surgery to remove the large intestine, with a new internal pouch constructed from the small intestine — called an ileal pouch-anal anastomosis (IPAA). This surgery can restore close-to-normal bowel function, but a common complication is pouchitis — inflammation of the pouch that causes diarrhoea, urgency, and discomfort. While antibiotics usually help, a significant number of people develop ongoing (chronic) pouchitis that doesn't respond to antibiotics. This trial is testing whether tofacitinib — a medication already approved for ulcerative colitis — is effective for treating antibiotic-resistant or antibiotic-dependent chronic pouchitis. Tofacitinib works by blocking specific inflammation-driving signals in immune cells, and since the inflammation in chronic pouchitis resembles that of ulcerative colitis, it may work similarly. Adults aged 18–65 with a previous ulcerative colitis diagnosis who have had an IPAA pouch surgery, and who experience chronic or recurrent pouchitis requiring more than 4 weeks of antibiotics in the past year (or pouchitis not responding to antibiotics), may be eligible. Significant heart disease risk, kidney impairment, active infections, or a history of certain immune conditions may disqualify you. Tofacitinib tablets are taken daily for the treatment period.