Tofacitinib is approved for which IBD scenario?

• A. Not approved for UC; only for Crohn's
• B. Approved for adults with moderate-to-severe ulcerative colitis who have had an inadequate response or intolerance to one or more TNF inhibitors
• C. Approved for pediatric ulcerative colitis
• D. Approved for all forms of inflammatory bowel disease as first-line therapy

Answer: (B)

This question tests where tofacitinib fits in ulcerative colitis treatment, specifically after exposure to TNF inhibitors. Tofacitinib is a Janus kinase (JAK) inhibitor taken orally that targets inflammatory signaling pathways. It is approved for adults with moderate-to-severe ulcerative colitis who have had an inadequate response or intolerance to one or more TNF inhibitors, providing an alternative mechanism when TNF blockade isn’t effective or tolerated.

It isn’t approved for Crohn’s disease, it isn’t approved for pediatric ulcerative colitis, and it isn’t indicated as first-line therapy or for all forms of inflammatory bowel disease. So the scenario best matching the approved use is adults with moderate-to-severe ulcerative colitis who have not adequately responded to TNF inhibitors.