Baricitinib for recalcitrant subacute cutaneous lupus erythematosus with concomitant frontal fibrosing alopecia

Kreuter, Alexander; Licciardi-Fernandez, M. J.; Burmann, S-N; Paschos, A; Michalowitz, Alena‐Lioba

doi:10.1111/ced.15044

Cited by 17 publications

(8 citation statements)

References 5 publications

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“… Resulted in complete remission of all lesions within 4 months. Kreuter (2021) 14 Case report Baricitinib 4mg daily for 2 months, then ongoing 2mg daily maintenance A 62-year-old woman with a 4-year history of FFA and SCLE resistant to several previous medications including chloroquine, hydroxychloroquine, methotrexate, azathioprine and rituximab. Resulted in complete clearance of SCLE and stopped further progression of FFA.…”

Section: Resultsmentioning

confidence: 99%

“…A 62-year-old woman showed complete clearance of SCLE after treatment with baricitinib 4 mg daily for 2 months followed by an ongoing daily maintenance dose of 2 mg. Interestingly, the treatment also halted the progression of this patient’s frontal fibrosing alopecia (FFA). 14 A case series of three patients with familial chilblain lupus (FCL) showed significant improvement of all cutaneous lesions after three months of baricitinib 4 mg daily. 15 Additional case reports displaying baricitinib’s efficacy are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…10 Conversely, systemic JAK inhibitors -including tofacitinib, ruxolitinib, and baricitinib -showed significant improvements in both skin lesions and hair regrowth. [11][12][13][14]16,17 The use of apremilast, a PDE-4 inhibitor, was also found to be efficacious in the treatment of CLE, with one study citing a significant reduction in CLASI after 85 days. 19 Additionally, the use of biologic therapies -including ustekinumab, tildrakizumab, anifrolumab, and BIIB059 -were effective in reducing cutaneous manifestations of CLE.…”

Section: Discussionmentioning

confidence: 99%

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Advancements in the Treatment of Cutaneous Lupus Erythematosus and Dermatomyositis: A Review of the Literature

Elhage¹,

Zhao²,

Nakamura³

2022

CCID

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Background Cutaneous lupus erythematosus (CLE) and dermatomyositis (DM) are autoimmune diseases that present with a wide variety of cutaneous manifestations. In both cases, first-line therapy includes topical corticosteroids. Patients may present with more widespread disease requiring systemic treatments, including corticosteroids, traditional immunosuppressants, or antimalarials. Due to their complex nature, both CLE and DM remain difficult to treat and continue to cause significant distress to patients. Objective To summarize the most recent literature on the safety and efficacy of novel treatment modalities for CLE and DM. Methods A literature search was conducted on PubMed using search terms “(dermatomyositis) AND (treatment)” and “(cutaneous lupus) AND (treatment)”. Additional search terms included specific names of biologic agents, phosphodiesterase inhibitors (apremilast), and JAK inhibitors. Results JAK inhibitors, PDE-4 inhibitors, and biologics have shown promise in reducing cutaneous symptoms of both CLE and DM, including reduction in SLE Disease Activity Index 2000 (SLEDAI-2K), Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), British Isles Lupus Assessment Group (BILAG), Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), and Disease Activity Score (DAS). Conclusion While there have been recent advancements in the treatment for CLE and DM, further research and clinical trials are required to better elucidate which therapy is best for individual patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Advancements in the Treatment of Cutaneous Lupus Erythematosus and Dermatomyositis: A Review of the Literature

Elhage¹,

Zhao²,

Nakamura³

2022

CCID

View full text Add to dashboard Cite

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“…Moreover, a case report showed promising results with JAK1/2 inhibitor. Subacute cutaneous lupus erythematosus (SCLE) with frontal fibrosing alopecia (FFA) presented a complete remission after 2 months of barcitinib therapy [ 63 ].…”

Section: Jak–stat Pathwaymentioning

confidence: 99%

Why Do We Need JAK Inhibitors in Systemic Lupus Erythematosus?

Richter

Cardoneanu

Burlui

et al. 2022

IJMS

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Systemic lupus erythematosus (SLE) is a chronic, multifactorial autoimmune disease with complex pathogenesis characterized by the imbalance of pro-inflammatory and anti-inflammatory cytokines. Janus kinases (JAKs), intracellular non-receptor tyrosine kinases, are essential for signal pathways of many cytokines. The JAK signal transducers and activators of transcription (STAT) pathways consist of four JAK kinases and seven STATs family members. The dysregulation of JAK-STAT pathways represents an important process in the pathogenesis of SLE. Thus, the use of therapies that target specific signaling pathways would be a challenge in SLE. It is well known that JAK inhibitors have real potential for the treatment of rheumatic diseases, but their efficacy in the treatment of SLE remains to be determined. JAK inhibitors are currently being investigated in phase II and III trials and are considered to become the next stage in SLE therapy. In this review, we report the current data regarding the efficacy of JAK inhibitors in SLE. The development of clinically useful kinase inhibitors might improve upon traditional therapeutic strategies.

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“…Two studies have described the use of JAK inhibitors in the treatment of CLE, using the SLE Disease Activity Index 2000 as the main end point which is not specific to skin disease (126,127). Baricitinib showed complete remission of a refractory papulosquamous rash in an SLE patient (128) and complete clearance of subacute CLE and no further progression of the FFA in a patient who was started on baricitinib 4 mg for 2 months, followed by ongoing maintenance therapy with baricitinib 2 mg (129).…”

Section: Janus Kinase Inhibitorsmentioning

confidence: 99%

An update on the management of refractory cutaneous lupus erythematosus

et al. 2022

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Management of cutaneous lupus erythematosus (CLE) involves a combination of preventive measures, topical and systemic drugs, fairly similar for the different subtypes. Although guidelines exist, to date, no specific drugs have been specifically licensed for CLE. Antimalarials remain the first-line systemic treatment, but many patients do not respond, making refractory lupus a challenge for clinicians. The choice of alternative medication should be based on effectiveness, safety and cost. Most of the available drugs for CLE have been adapted from systemic lupus erythematosus (SLE) treatment but the existing literature is limited to small studies and evidence often lacks. As knowledge of pathogenesis of both CLE and SLE is improving, promising new therapies are emerging. In this review, we discuss the available medications, focusing on the novelties under development for CLE.

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Baricitinib for recalcitrant subacute cutaneous lupus erythematosus with concomitant frontal fibrosing alopecia

Cited by 17 publications

References 5 publications

Advancements in the Treatment of Cutaneous Lupus Erythematosus and Dermatomyositis: A Review of the Literature

Advancements in the Treatment of Cutaneous Lupus Erythematosus and Dermatomyositis: A Review of the Literature

Why Do We Need JAK Inhibitors in Systemic Lupus Erythematosus?

An update on the management of refractory cutaneous lupus erythematosus

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