Tofacitinib for the Treatment of Pyoderma Gangrenosum

Kochar, Bharati; Herfarth, Neel; Mamie, Céline; Navarini, Alexander A.; Scharl, Michael; Herfarth, Hans H

doi:10.1016/j.cgh.2018.10.047

Cited by 58 publications

(44 citation statements)

References 7 publications

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“…Tofacitinib is an oral JAK 1 and 3 inhibitor that is currently approved for use in RA and ulcerative colitis. Three patients with treatment-resistant PG and both comorbid Crohn’s disease and inflammatory arthritis were given tofacitinib, leading to complete resolution in two patients and symptom improvement in the third by 12 weeks 45 .…”

Section: Treatmentmentioning

confidence: 99%

Recent advances in managing and understanding pyoderma gangrenosum

2019

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Pyoderma Gangrenosum (PG) is a rare neutrophilic dermatosis with multiple different clinical presentations and associated comorbidities. PG has historically been a challenging disorder to diagnose, leading to the development of new diagnostic criteria rather than the traditional approach of a diagnosis of exclusion. The pathophysiology is thought to involve both innate and adaptive immune system dysregulation, neutrophilic abnormalities, environmental, and genetic factors. As of today, no gold standard therapy exists for the treatment of PG, and the literature is restricted to mainly case reports, case series, and 2 small randomized clinical trials. Topical, systemic, and biologic therapy, as well as adequate analgesia and proper wound care all play a role in the management of PG. Recent studies have identified additional cytokines and signalling cascades thought to be involved in the pathogenesis of PG, ultimately leading to the development of new targeted therapies. This review will focus on recent advances in the pathophysiology, clinical presentation and associated comorbidities, diagnosis, and management of PG.

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Section: Treatmentmentioning

confidence: 99%

Recent advances in managing and understanding pyoderma gangrenosum

2019

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“… 3 After the patient's initial improvement with adalimumab followed by recurrence of his pyoderma gangrenosum, tofacitinib was chosen because it has also been used in other cases of pyoderma gangrenosum. 4 This case highlights a rare, protracted course of an increasingly reported entity of levamisole-induced pyoderma gangrenosum that demonstrated significant initial improvement with multiple systemic immunosuppressants, and ultimately achieved remission with tofacitinib.…”

Section: Discussionmentioning

confidence: 82%

Recalcitrant and severe pyoderma gangrenosum attributable to levamisole-adulterated cocaine and treated successfully with oral tofacitinib

et al. 2020

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“…Oral tofacitinib 5–10 mg twice daily given to three patients with Crohn's disease (primarily for associated severe inflammatory arthritis) and PG refractory to biologics, resulted in resolution of all PG lesions in 12 weeks. [32] Oral tofacitinib 5 mg two to three times daily given for 2–19 months in combination with other immunomodulatory therapies such as low-dose methotrexate reportedly produced significant improvement in patients with generalized deep morphea and eosinophilic fasciitis nonresponsive to corticosteroids, and in patients with treatment-recalcitrant lichen planopilaris. [3334]…”

Section: Clinical Use Of Oral Tofacitinib In Skin Disorders: An Appramentioning

confidence: 99%

Oral tofacitinib: Contemporary appraisal of its role in dermatology

Sonthalia

Aggarwal

2019

Indian Dermatol Online J

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Tofacitinib, an oral Janus kinase inhibitor (Jakinib), is an emerging treatment modality whose well-established efficacy in systemic inflammatory diseases is now being actively explored for cutaneous disorders (arising due to the patient's dysimmune responses) that are not responding to and/or sustaining intolerable adverse effects with the classical immunosuppressives and other targeted therapies such as the biologics. The most common dermatoses for which oral as well as topical Jakinibs such as tofacitinib have been evaluated and are being used albeit as an off-label indication include psoriasis, psoriatic arthritis, alopecia areata, vitiligo, and atopic dermatitis. This article provides a succinct review on the current status of oral tofacitinib in dermatology through literature search of PubMed database and stresses on the need for further evidence generation to define the drug's place in the therapeutic arsenal of dysimmune cutaneous disorders.

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Tofacitinib for the Treatment of Pyoderma Gangrenosum

Abstract: The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.

Cited by 58 publications

References 7 publications

Recent advances in managing and understanding pyoderma gangrenosum

Recent advances in managing and understanding pyoderma gangrenosum

Recalcitrant and severe pyoderma gangrenosum attributable to levamisole-adulterated cocaine and treated successfully with oral tofacitinib

Oral tofacitinib: Contemporary appraisal of its role in dermatology

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