JAK inhibitors feasible treatment option for patients with Pyoderma gangrenosum

"JAK (Janus kinase) inhibitors are a welcome addition to our options for managing patients with pyoderma gangrenosum," the authors wrote in his study published in the International Journal of Dermatology.

The author presents two pyoderma gangrenosum cases successfully treated with JAK inhibitors. A male aged 73 years experienced complete regression of PG lesions to his axilla after three weeks on baricitinib 2 mg twice daily and no relapses within 24 months of follow-up. A female aged 89 with PG on her foot and legs experienced resolution of lesions after 120 days of tofacitinib 5 mg twice daily and no relapses within eight months of follow-up.

Pyoderma gangrenosum is a rare condition that leads to the development of large, painful sores (ulcers) on the skin, most often on the legs. The exact causes of PG are unknown, but it appears to be an immune system disorder. Currently, the condition lacks standardized therapy, and there is a need for safer and more efficacious treatments.

Luiz G. M. Castro, Albert Einstein Israelite Hospital, São Paulo, Brazil, described two new PG cases treated with JAK inhibitors, adding to the small existing experience. The two patients with pyoderma gangrenosum were successfully treated with tofacitinib and baricitinib.

Patient # 1 was treated with baricitinib 2 mg bid for 39 days, while patient # 2 used tofacitinib 5 mg bid for 120 days. According to the study, both patients were cured and presented no relapse. No adverse reactions were seen.

"The increasing usage of JAK inhibitors for treating inflammatory diseases positively affected PG therapy," Dr Castro wrote. "Fifteen PG cases treated with these drugs had been found in literature, and the two new cases described here add to the limited existing experience."

"This is a novel use of baricitinib and tofacitinib beyond the approved indications," he concluded. "JAK inhibitors are a welcome addition to our options to manage patients with Pyoderma gangrenosum."

Reference:

M. Castro, L. G. JAK inhibitors: A novel, safe, and efficacious therapy for pyoderma gangrenosum. International Journal of Dermatology. https://doi.org/10.1111/ijd.16676