Tofacitinib-Associated Cerebral Venous Sinus Thrombosis

Tofacitinib is a Janus kinase inhibitor indicated to treat adult patients with moderately to severely active ulcerative colitis (UC). Although thrombosis is a known adverse event of tofacitinib, there are no reports specific to cerebral venous sinus thrombosis (CVST). We present a report of a patient presenting with a CVST several months after starting tofacitinib. Initially, this 60-year-old man with poorly controlled UC who previously had a nonthrombotic hemorrhage was found to have venous sinus thromboses of the right transverse and sigmoid sinuses. Hematological workup did not reveal any underlying hypercoagulable conditions, aside from UC. This is the first report of a patient with CVST likely resulting from the Janus kinase inhibitor tofacitinib. This case report should prompt compilation of all thrombotic events in patients receiving tofacitinib.