Clinical evidence from the OCTAVE trials showed that tofacitinib is more effective than placebo for induction and maintenance treatment of moderate-to-severe disease, regardless of whether TNF-alpha inhibitors have been taken previously. For patients who had not had a TNF-alpha inhibitor, tofacitinib was shown to be more effective than adalimumab and golimumab as maintenance treatment. For those who had had a TNF-alpha inhibitor, tofacitinib was shown to be more effective than adalimumab as induction treatment. The committee considered tofacitinib a cost-effective treatment due to the health-related benefits and costs compared with conventional therapy and biologicals. Tofacitinib could therefore be recommended as a treatment for moderately to severely active ulcerative colitis in adults whose disease has responded inadequately to, or who cannot tolerate, conventional or biological therapy.