Introduction

Ulcerative colitis (UC) management focuses on inducing and maintaining remission (symptom resolution and endoscopic healing) with 5-aminosalicylic acid medications, steroids, and immunosuppressants. However, these are associated with low response rates (30%-60%) and a high risk of hospitalization and colectomy still exists. Tofacitinib, a Janus kinase (JAK) inhibitor, offers significant clinical benefits with favorable prognosis and is approved for use in moderate-to-severe active UC, particularly for those who have not responded to conventional therapies, failed previous treatments, or are intolerant to them. Vast literature is available on tofacitinib in UC which will aid to construct a knowledge map for future research.

Aim

To perform a bibliometric analysis to delineate disciplinary evolution, current state,  and identify research hotspots and developmental trends of tofacitinib in UC (2012 – 2024)

Data Profile

• 406 studies related to tofacitinib in UC treatment from a total of 151 journals

Method

Study Design

• Comprehensive literature review
• The articles were identified from Web of Science Core Collection database (WOSCC) for analysis and visualization

Results

• Over the past 12 years (2012-2024), a significant increase in the number of annual publications on tofacitinib treatment in UC research have been observed (2 publications in 2012, 84 in 2022 and 73 in 2024)
• The knowledge map displayed strong institutional collaborations and significant global contributions (107 institutions and 202 links), especially from the United States and Europe

• Science Citation Index (SCI) research articles were mainly from the United States (n = 199), followed by Italy (n = 63), Canada (n = 57), Spain (n = 56), and Germany (n = 46); Asia was the lowest contributor (Japan, n = 40)
• Prominent researchers, Su Chinyu, William J. Sandborn, Julian Panés, et al. collaborated extensively for comprehensive research in the underlying causes of UC and to assess the clinical effectiveness and safety of tofacitinib in real-world settings.
• The highest number of publications and the fourth-highest citation count were on Inflammatory Bowel Disease (57 articles), which clearly pointed towards clinical research regarding tofacitinib in UC
• The New England Journal of Medicine was the most frequently cited journal (344 citations)
• The paper “Tofacitinib as Induction and Maintenance Therapy for Ulcerative Colitis,” published in the New England Journal of Medicine in 2017 as part of the Tofacitinib series, ranked first with 1,163 citations
• Initially, tofacitinib was used for rheumatoid arthritis treatment, and since 2011, it has been explored as a therapeutic option for UC
• The top 10 most co-cited publications revolved around efficacy and safety evaluation of tofacitinib in UC
• Recent studies had concentrated mainly on assessing the clinical efficacy and safety of tofacitinib in patients with moderate-to-severe UC, the effectiveness of combination and comparative therapies, and its role in maintaining the intestinal barrier
• Keyword analysis revealed that the intestinal barrier, clinical response, remission rate, and safety have been the central themes of current research
• Keywords with the strongest burst intensities included “Janus kinase inhibitor” (5.94), “Crohn’s disease” (4.01), and “placebo” (3.1), demonstrating their prominent relevance to researchers during the specific time intervals.
• Current research underscored that tofacitinib was an effective and safe treatment option for refractory UC, particularly in patients with moderate-to-severe disease who were unresponsive to corticosteroids or vedolizumab
• By reducing the need for colectomy, tofacitinib showed significant potential in the clinical management of UC

Safety

• The key terms “treatment response” and “herpes zoster” reflected the current areas of focus in the field
• UC patients undergoing tofacitinib therapy may experience adverse reactions, such as herpes zoster, following standard induction or maintenance dosing

Conclusion

• By applying bibliometrics, citation analysis, and knowledge mapping, this study provided insight on currently ongoing and future research trajectory of tofacitinib in UC along with emphasis on multidisciplinary collaboration in advancing UC therapeutic strategies
• Overall, tofacitinib demonstrated substantial promise for future clinical applications in the treatment of UC

Front. Pharmacol. 16: 1570238