Can Tofacitinib/Shangjie be taken for a long time?

Tofacitinib is a small molecule oral JAK inhibitor mainly used to treat chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis. This type of disease often has a long course and requires continuous management, so many patients are concerned about whether tofacitinib can be taken for a long time.

From a mechanism of action, tofacitinib reduces the excessive activation of inflammatory factors by blocking theJAK pathway, thereby controlling disease activity. Because it is a targeted immunomodulatory drug, not a short-term analgesic or a simple anti-inflammatory drug, long-term use is justified under appropriate monitoring and management. In fact, overseas guidelines and clinical practice have included tofacitinib as a maintenance treatment option for chronic inflammatory diseases, especially for patients who have poor response to or intolerance to TNF inhibitors.

However, long-term use of tofacitinib must be conducted under strict medical monitoring. Research and regulatory agencies suggest that long-term use of this drug may increase the risk of serious infections, shingles, blood clots, and cardiovascular events. Especially among elderly patients, people with underlying heart disease or long-term smokers, these risks need to be paid attention to. Therefore, doctors usually conduct a comprehensive assessment before treatment, including tuberculosis screening, liver and kidney function tests, and hematology tests, and regularly follow up blood routine, blood lipids, and liver function during medication so that dosage can be adjusted or medication discontinued in a timely manner.

In addition, tofacitinib is not suitable for indefinite use, and long-term treatment strategies for patients often need to be individualized. For example, in ulcerative colitis, induction therapy is often initiated at higher doses, with a gradual transition to maintenance doses based on clinical response. If a patient achieves durable remission during the maintenance phase, doctors may reassess whether to continue long-term medication.

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