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

KÖKEN AVŞAR A., DEMİRCİ YILDIRIM T., SARI İ.

Rheumatology International, vol.44, no.10, pp.2227-2237, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 44 Issue: 10
  • Publication Date: 2024
  • Doi Number: 10.1007/s00296-024-05560-1
  • Journal Name: Rheumatology International
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, Veterinary Science Database
  • Page Numbers: pp.2227-2237
  • Keywords: Case report, Jak inhibitors, Pyoderma gangrenosum, Tofacitinib
  • Dokuz Eylül University Affiliated: Yes

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.