We would like to thank Dr Ng for the interest and comments regarding our study ‘Real-world Effectiveness of Tofacitinib for Moderate to Severe Ulcerative Colitis: A Multicentre UK Experience’.1 The comments pertain to the plausibility of stable haemoglobin [Hb] levels in the context of moderately to severely active disease, which did not increase with therapy, and the significance of tofacitinib-induced hyperlipidaemia in our study cohort.Whereas we agree that serum Hb may be used as a surrogate marker for disease severity in ulcerative colitis, Dr Ng correctly points out that in our cohort the baseline median Hb was normal, 134 g/L (interquartile range [IQR] 123–146). Therefore it is entirely plausible and indeed unsurprising that after response to tofacitinib, Hb levels remained within the normal range. Inflammatory bowel disease [IBD]-associated anaemia from the combination of chronic iron deficiency and anaemia of chronic disease is prevalent but does not affect all patients.2 Other markers of active disease, which were elevated at baseline, including partial Mayo Score, Simple Clinical Colitis Activity Index, faecal calprotectin, and Ulcerative Colitis Endoscopic Index of Severity, fell significantly with tofacitinib therapy during follow-up.
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