Tofacitinib therapy for severe pyoderma gangrenosum in a patient with enteropathic arthritis: a case-based review.

IF 3.2 3区医学 Q2 RHEUMATOLOGY

Rheumatology International Pub Date : 2024-10-01 Epub Date: 2024-03-15 DOI:10.1007/s00296-024-05560-1

Aydan Köken Avşar, Tuba Demirci Yıldırım, İsmail Sarı

引用次数: 0

Abstract

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that is associated with systemic inflammatory conditions. Currently, there is no universally accepted standard therapy for PG, but immunosuppressive (IS) treatment seems essential. We report a patient here who was successfully treated with tofacitinib despite being PG-refractory to multiple anti-tumor necrosis factor alpha (anti-TNF) therapies and conventional IS. In addition, we performed a comprehensive review of all cases of PG treated with JAK inhibitors. We identified 27 cases treated with JAK inhibitors. Approximately 80% of the patients achieved complete recovery within a median of 12 weeks, even though 17 patients (63%) had received biologics before JAKinib treatment. Notably, this recovery could appear as early as 2 weeks. JAK inhibitors may prove useful in the future, particularly for treating immunosuppressive and steroid-resistant pyoderma gangrenosum, according to recent case reports.

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托法替尼治疗肠病性关节炎患者的严重脓皮病：病例回顾。

坏疽性脓皮病（PG）是一种罕见的嗜中性皮肤病，与全身炎症有关。目前，脓皮病还没有公认的标准疗法，但免疫抑制（IS）治疗似乎是必不可少的。我们在此报告了一名患者，尽管他对多种抗肿瘤坏死因子α（anti-TNF）疗法和传统的IS治疗无效，但却成功地接受了托法替尼治疗。此外，我们还对所有接受JAK抑制剂治疗的PG病例进行了全面回顾。我们发现了 27 例接受 JAK 抑制剂治疗的病例。约80%的患者在12周的中位时间内实现了完全康复，尽管有17名患者（63%）在接受JAKinib治疗前曾接受过生物制剂治疗。值得注意的是，这种恢复最早可在2周内出现。根据最近的病例报告，JAK抑制剂将来可能会被证明是有用的，尤其是在治疗免疫抑制性和类固醇耐药的脓皮病方面。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.