{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:47:10Z","timestamp":1789055230249,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Inc. ASPIRE program","award":["63176101"],"award-info":[{"award-number":["63176101"]}]},{"name":"Pfizer Inc. ASPIRE program","award":["PI21\/01086"],"award-info":[{"award-number":["PI21\/01086"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["63176101"],"award-info":[{"award-number":["63176101"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI21\/01086"],"award-info":[{"award-number":["PI21\/01086"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Plan Estatal de Investigaci\u00f3n Cient\u00edfica y T\u00e9cnica y de Innovaci\u00f3n","award":["63176101"],"award-info":[{"award-number":["63176101"]}]},{"name":"Plan Estatal de Investigaci\u00f3n Cient\u00edfica y T\u00e9cnica y de Innovaci\u00f3n","award":["PI21\/01086"],"award-info":[{"award-number":["PI21\/01086"]}]},{"name":"ISCIII\u2014Subdirecci\u00f3n General de Evaluaci\u00f3n y Fomento de la Investigaci\u00f3n","award":["63176101"],"award-info":[{"award-number":["63176101"]}]},{"name":"ISCIII\u2014Subdirecci\u00f3n General de Evaluaci\u00f3n y Fomento de la Investigaci\u00f3n","award":["PI21\/01086"],"award-info":[{"award-number":["PI21\/01086"]}]},{"name":"European Regional Development","award":["63176101"],"award-info":[{"award-number":["63176101"]}]},{"name":"European Regional Development","award":["PI21\/01086"],"award-info":[{"award-number":["PI21\/01086"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Tofacitinib is effective for refractory ulcerative colitis (UC), a chronic inflammatory disease of the colonic mucosa. However, its use has been associated with an increased risk of thromboembolic events, prompting regulatory restrictions. Understanding the pathophysiological mechanisms contributing to these potential risks is critical for patient safety. We aim to evaluate and compare ex vivo the effects of tofacitinib and anti-TNF on coagulation parameters and platelet function. Methods: Whole blood and platelet-rich plasma from 10 active UC (aUC) and 10 quiescent UC (qUC) patients and 10 healthy controls (HC) were spiked ex vivo with tofacitinib, anti-TNF (as comparator), or a sterile solution. Coagulation kinetics were measured by rotational thromboelastometry (ROTEM), platelet aggregation by aggregometry, and platelet activation by flow cytometry. The study was conducted at Hospital Universitario de La Princesa. Results: Flow cytometry showed increased expression of activation markers CD62P and CD63 and higher PAC-1 binding in platelets from both aUC and qUC patients incubated with either tofacitinib or anti-TNF versus no drug. No differences were found between the drugs. CD63 expression also increased in HC after drug exposure, with no differences between anti-TNF or tofacitinib. Platelet aggregation and coagulation parameters did not differ between tofacitinib, anti-TNF, and no drug in aUC, qUC, and HC. Conclusions: Tofacitinib does not alter platelet function or coagulation in UC patients under ex vivo conditions compared to anti-TNF. The increased thromboembolic risk observed in some populations treated with tofacitinib cannot be attributed to these factors in UC patients.<\/jats:p>","DOI":"10.3390\/ph18040557","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T07:41:51Z","timestamp":1744270911000},"page":"557","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Tofacitinib on Hemostasis in Patients with Ulcerative Colitis: A Comparative Ex Vivo Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Cristina","family":"S\u00e1nchez-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Suarez-Trujillo","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8005-2411","authenticated-orcid":false,"given":"Irene","family":"Soleto","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Mercado","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7670-1848","authenticated-orcid":false,"given":"Macarena","family":"Orejudo","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula J.","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Rubio Collado","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario de La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Orts","sequence":"additional","affiliation":[{"name":"Servicio de Anestesiolog\u00eda y Reanimaci\u00f3n, Hospital Universitario de La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Rubio Franco","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario de La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Planas","sequence":"additional","affiliation":[{"name":"Servicio de Anestesiolog\u00eda y Reanimaci\u00f3n, Hospital Universitario de La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Acedo","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario de La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-7150","authenticated-orcid":false,"given":"Nora","family":"Butta","sequence":"additional","affiliation":[{"name":"Grupo de Coagulopat\u00edas y Trastornos de la Hemostasia, Hospital Universitario de La Paz-IdiPAZ, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-4242","authenticated-orcid":false,"given":"Mar\u00eda","family":"Chaparro","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2090-3445","authenticated-orcid":false,"given":"Javier P.","family":"Gisbert","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0848-8154","authenticated-orcid":false,"given":"Montse","family":"Bald\u00e1n-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid (UAM), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1016\/S0140-6736(12)60150-0","article-title":"Ulcerative colitis","volume":"380","author":"Eckmann","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/gutjnl-2012-302311","article-title":"Work disability in inflammatory bowel disease patients 10 years after disease onset: Results from the IBSEN study","volume":"62","author":"Moum","year":"2013","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1136\/bmj.333.7563.340","article-title":"Ulcerative colitis: Diagnosis and management","volume":"333","author":"Collins","year":"2006","journal-title":"Br. 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