Oral tofacitinib: a promising treatment in atopic dermatitis, alopecia areata and vitiligo

Vu, Mi; Heyes, Christopher; Robertson, Susan J.; Varigos, George; Ross, Gayle

doi:10.1111/ced.13290

Cited by 44 publications

(44 citation statements)

References 5 publications

(11 reference statements)

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“…For instance, Vu et al reported a patient with AD, vitiligo, and AA who was treated with tofacitinib 5 mg twice daily. After 6 months of treatment, the patient experienced a marginal, partial, and complete response of vitiligo, AA, and AD, respectively . Other immunomodulators, however, have been tried in patients with a similar combination of disorders.…”

Section: Discussionmentioning

confidence: 99%

Effective use of oral tofacitinib and phototherapy in a patient with concomitant alopecia areata, vitiligo, and plaque and inverse psoriasis

Tajalli

Kabir

Vance

et al. 2020

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Effective use of oral tofacitinib and phototherapy in a patient with concomitant alopecia areata, vitiligo, and plaque and inverse psoriasis

Tajalli

Kabir

Vance

et al. 2020

Clinical Case Reports

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“…One such example is the response of both disorders to the inhibitors of Janus kinase (JAK) pathway . Tofacitinib citrate, a JAK inhibitor, has been found to have a promising role in the treatment of both AD and vitiligo . By inhibiting the JAK‐STAT pathway, JAK inhibitors work in AD by disrupting IL‐4 signaling, a crucial cytokine in Th2 cell differentiation in AD .…”

Section: Discussionmentioning

confidence: 99%

“…Tofacitinib citrate, a JAK inhibitor, has been found to have a promising role in the treatment of both AD and vitiligo . By inhibiting the JAK‐STAT pathway, JAK inhibitors work in AD by disrupting IL‐4 signaling, a crucial cytokine in Th2 cell differentiation in AD . On the other hand, inhibition of the JAK‐STAT pathway also downregulates interferon‐gamma signaling and prevents depigmentation in vitiligo .…”

Section: Discussionmentioning

confidence: 99%

Association of atopic dermatitis with vitiligo: A systematic review and meta‐analysis

Acharya

Mathur

2019

J of Cosmetic Dermatology

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Background Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with multiple immune‐mediated disorders. A comprehensive meta‐analysis assessing the prevalence or risk of vitiligo in AD patients is lacking. Objective To compare the prevalence and assess the risk of vitiligo in patients with AD by performing a meta‐analysis of observational studies. Methods PubMed, Scopus, and Cochrane databases were systematically searched until August 25, 2019, following the PRISMA guidelines. Published English‐language articles including case‐control, cross‐sectional, or cohort studies that reported either odds or risk of vitiligo in AD patients were included. Full‐text review and study assessment were performed by the two authors independently. Random‐effects meta‐analysis model was used to calculate the odds ratio (OR) and risk ratio (RR) with the corresponding 95% confidence interval (CI). The risk of bias was assessed using the Newcastle‐Ottawa Scale. Results Seven studies with a total of 1 540 688 unique AD patients were included. The random‐effects meta‐analysis of case‐control and cross‐sectional studies showed a significant association of AD with vitiligo (OR, 3.21; 95% CI, 1.90‐5.43). Subgroup analyses also showed a significant association for both adult AD (OR, 4.46; 95% CI, 1.65‐12.07) and childhood AD (OR, 2.83; 95% CI, 1.53‐5.25). Pooling of the results of 2 cohort studies showed an increased risk of vitiligo in patients with AD (RR, 1.64; 95% CI, 1.27‐2.13). Conclusions Results from this study support an association of AD with vitiligo. Exploration of possible mechanisms responsible for this association could be important to develop proper treatment approaches for the affected patients.

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“…133 Oral tofacitinib is also effective for deceasing severity and itching in AD in some case series, but further clinical trials with larger sample sizes are warranted to validate the efficacy. 134,135 In a murine model of AD, a PAR2 antagonist PZ-235 significantly inhibits PAR2-mediated inflammation and epidermal thickening and reduces pruritus, suggesting PAR2 as a therapeutic target for AD. 136…”

Section: Small Molecule Drugsmentioning

confidence: 99%

“…JTE-052 is a novel JAK inhibitor, which can inhibit JAK1/JAK2/JAK3 pathways as well as the Th1-, Th2-, Th17-mediated inflammation and relieve itching induced by IL-31. Oral tofacitinib is also effective for deceasing severity and itching in AD in some case series, but further clinical trials with larger sample sizes are warranted to validate the efficacy 134,135. JTE-052 has obvious effects and works fast in the treatment for moderate-to-severe AD by topical use in a clinical phase 2 clinical trial 132.…”

mentioning

confidence: 99%

Immune mediators and therapies for pruritus in atopic dermatitis and psoriasis

Zhou

et al. 2019

J Cutaneous Imm & Allergy

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractAtopic dermatitis (AD) and psoriasis (Pso) are two common inflammatory skin diseases which are symptomatically characterized by pruritus to variable degrees.Whereas AD is nearly always associated with pruritus, only 50%-70% of patients with Pso suffer from itching. Within the last decade, the development of biologic agents targeting specific cytokines or cytokine receptors has led to tremendous progress in suppressing inflammation (and thus improving quality of life) in these two diseases.While suppressing inflammation would generally reduce pruritus in these inflammatory diseases, pruritus is still recalcitrant for treatment in some patients due to relative lack of therapeutics that specifically inhibit pruritus signaling. There is abundant evidence that certain cytokines and neuropeptides-ion channels signaling mediate pruritus that is independent of inflammation in AD and psoriasis. Of note, Janus kinase (JAK) and nerve growth factor (NGF)-tropomyosin receptor kinase A (TrkA)transient receptor potential vanilloid 1 (TRPV1) signaling partially regulates pruritus in AD and psoriasis. JAK kinases inhibitors decrease the extent of itch in patients with AD and psoriasis. In clinical trials, topical inhibitors of TrkA and TRPV1 have been reported to reduce pruritus in patients with Pso and AD, respectively. In this article, we review recent literature knowledge regarding the mechanisms underlying pruritus in AD and Pso, providing hypotheses for why pruritus may be more common in AD than in Pso. In light of the different mechanisms underlying these two diseases, the current and developing therapeutics, either in human clinical trials or animal studies, for targeting pruritus are also discussed. K E Y W O R D SIL-31, neuropeptide, PAR2, SP, thymic stromal lymphopoietin, TRPA1, TRPV1

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Oral tofacitinib: a promising treatment in atopic dermatitis, alopecia areata and vitiligo

Abstract: Click https://www.wileyhealthlearning.com/ced.aspx for the corresponding questions to this CME article.

Cited by 44 publications

References 5 publications

Effective use of oral tofacitinib and phototherapy in a patient with concomitant alopecia areata, vitiligo, and plaque and inverse psoriasis

Effective use of oral tofacitinib and phototherapy in a patient with concomitant alopecia areata, vitiligo, and plaque and inverse psoriasis

Association of atopic dermatitis with vitiligo: A systematic review and meta‐analysis

Immune mediators and therapies for pruritus in atopic dermatitis and psoriasis

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