Tofacitinib for refractory ocular mucous membrane pemphigoid.

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Ocular mucous membrane pemphigoid (MMP) is a chronic autoimmune blistering disease affecting the conjunctiva.
• Refractory cases pose significant treatment challenges and risk vision loss due to progressive fibrosis.

Observation:

• Two patients with severe, refractory ocular MMP were treated with tofacitinib.
• Both patients experienced rapid control of conjunctival inflammation within eight weeks of treatment initiation.

Findings:

• Tofacitinib demonstrated durable control of ocular inflammation and prevented further subconjunctival fibrosis progression.
• One patient maintained disease remission for 16 months, while the other relapsed upon discontinuation and improved upon re-initiation of tofacitinib.

Implications:

• Tofacitinib, a Janus kinase inhibitor, represents a promising therapeutic option for severe, treatment-resistant ocular MMP.
• This suggests a potential role for targeted immunomodulation in managing this debilitating condition.