Tofacitinib Versus Cyclosporine for Steroid Refractory Acute Severe Ulcerative Colitis

Exclusion Criteria

• •Age \<18, Age \> 65 years
• •* E1 disease (involvement distal to rectosigmoid junction only)
• •* Crohn's disease
• •* Contraindication to intravenous cyclosporine or oral tofacitinib
• •* Renal failure, uncontrolled hypertension, seizure disorder,and uncorrected hypomagnesemia (\<1.5 mg/L)
• •* Previous thrombosis, or prothrombotic state, on oral contraceptive, history of herpes zoster, active TB, active hepatitis, past opportunistic infections, h/o diverticulitis, Age \>50 plus at least one cardiac risk factor
• •* Patient wants treatment with intravenous infliximab or wants surgery
• •* Underlying sepsis or active infection (Enteric infections, Clostridium difficile, active hepatitis B or C, Tuberculosis, zoster, CMV disease)
• •* Toxic megacolon, previous dysplasia or any indication of immediate surgery
• •* Known malignancy
• •* Pregnancy or Lactation
• •* Unwilling to provide consent or for follow-up