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Published on: February 8, 2019
Tofacitinib therapy for severe pyoderma gangrenosum in a patient with enteropathic arthritis: a case-based review
Aydan Köken Avşar1, Tuba Demirci Yıldırım2, İsmail Sarı2
1Department of Rheumatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. aydankoken@hotmail.com.
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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