Can't I stop taking Tofacitinib/Shangjie once I use it?

Many patients will worry after starting to use Tofacitinib/Shangjie(Tofacitinib): "Can I not stop this drug once I take it?" This question is very common and reflects patients' concerns about long-term immunotherapy. In fact, whether tofacitinib can be discontinued requires a comprehensive judgment based on the nature of the disease, condition control, and doctor's advice. There is no absolute situation that "once used, it cannot be stopped for life."

Tofacitinib is a selectiveJAK inhibitor, which is an immunomodulatory drug. Its function is to inhibit abnormally excessive inflammatory reactions and is used to control long-term immune diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis. This type of disease is often chronic and progressive. If it relies entirely on the body's own regulation, most patients will have difficulty maintaining a stable state. Therefore, drugs such as tofacitinib often require regular treatment for a certain period of time to maintain disease stability. This is also the reason why it is not recommended for some patients to stop taking the medicine at will after long-term use.

But that doesn’t mean you can’t stop taking your medication. For some patients whose condition is stable, whose inflammatory indicators have declined, and whose symptoms have been significantly relieved, doctors may gradually reduce the dose based on efficacy and safety evaluation, or even try to discontinue the drug for observation. Especially in diseases such as rheumatoid arthritis, when disease activity drops to a low level, a large number of international guidelines support "de-escalation therapy can be tried after remission," which includes cautiously reducing the dose of tofacitinib. The key is whether the doctor leads the discontinuation strategy, rather than the patient discontinuing the medication on their own.

It should be noted that sudden discontinuation of tofacitinib may lead to disease rebound, especially in patients with ulcerative colitis who may experience reactivation of symptoms. Therefore, before deciding to discontinue medication, doctors often judge whether the conditions for discontinuation are met based on imaging, blood indicators, and the patient's clinical manifestations.

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