We describe a case of refractory
pouchitis successfully treated with
tofacitinib. The patient was a 20-year-old woman diagnosed with
ulcerative colitis at the age of 14 years. She underwent surgery at the age of 18 years for chronic active
inflammation, despite an optimal medication regimen. Ten months after surgery, she was diagnosed with
pouchitis. She did not respond to conventional
conservative treatment; thus, the case was considered as that of refractory chronic
pouchitis. Anti-
tumor necrosis factor-α (TNF-α)
therapy was administered, which led to some improvement; however,
pouchitis recurred. Systemic
steroid and
vedolizumab were also administered, but the response was unsatisfactory. Therefore, surgery was considered; however, the patient refused to undergo surgery. As identical
therapies are recommended for
ulcerative colitis and
pouchitis, they are considered to have a common etiology. Therefore, we considered
tofacitinib therapy in this case. After obtaining the patient's informed consent,
tofacitinib treatment was initiated. The
therapy led to improvement in her symptoms as well as in the appearance of the pouch when observed on endoscopy, and surgery was avoided. Thus,
tofacitinib may be considered a
therapy option for refractory chronic
pouchitis.