Janus Kinase Inhibitors for the Treatment of Pediatric Morphea: A Systematic Review

Morphea, also known as localized scleroderma (LoS), is an inflammatory, fibrosing dermatologic disorder of the skin and underlying tissues with associated comorbidities including joint contractures, limb-length discrepancies, and inflammatory arthropathy occurring more commonly in children. While standardized consensus treatment plans for pediatric LoS have been developed by the Childhood Arthritis and Rheumatology Research Alliance, the use of Janus kinase (JAK) inhibitors in the treatment of pediatric LoS has recently been reported. This review, which systematically summarizes the published literature on the use of oral and topical JAK inhibitors for pediatric LoS, identified nine studies (involving 16 patients across all studies) that met inclusion criteria with improvement following JAK inhibitor initiation reported in 94% (n = 15) of cases. Overall, these findings demonstrate that JAK inhibitors may offer a promising alternative to treat pediatric morphea; however, more robust studies are required to evaluate the efficacy of JAK inhibitors in treating pediatric LoS.