Rheumatoid arthritis drug may benefit atopic dermatitis patients

Patients with moderate to severe atopic dermatitis (AD)-or eczema-may be successfully treated using a rheumatoid arthritis (RA) drug recently shown to reverse 2 other skin conditions, vitiligo and alopecia areata, according to findings published early online in the Journal of the American Academy of Dermatology.

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AD is a chronic condition that causes severe itching and leaves the skin red and thickened. It can adversely affect sleep and quality of life.

Researchers at Yale School of Medicine found that treatment with tofacitinib citrate led to dramatic improvement in patients with moderate to severe AD who had previously tried conventional therapies without success. Based on current scientific models of AD biology, Brett King, MD, PhD, assistant professor of dermatology, Yale University School of Medicine, hypothesized that tofacitinib would interrupt the immune response that causes AD.

In the study, 6 consecutive patients with moderate to severe disease (defined as body surface area involvement >10% and Scoring of AD (SCORAD) index >20 were treated with tofacitinib 5 mg twice daily (1 patient took only 5 mg once daily) for up to 29 weeks, monitoring the SCORAD during the treatment period to evaluate changes in their condition from prior to treatment. The patients’ condition had previously failed common and uncommon therapies for AD prior to treatment with tofacitinib.

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All 6 patients reported significant reduction in itch as well as improved sleep during treatment, as well as diminished redness and thickening of the skin.

“Tofacitinib was efficacious in treating the signs and symptoms of the disease. Tofacitinib may be the first available targeted therapy for moderate to severe atopic dermatitis,” Dr King said.

King and fellow Yale dermatologist Brittany Craiglow, MD, had previously shown that tofacitinib citrate regrows hair in patients with an autoimmune-related form of hair loss called alopecia areata. They also published findings reporting the successful treatment of a patient with vitiligo, which can leave widespread irregular white patches all over the body.

Further research is needed to confirm the treatment’s long-term efficacy and safety for AD patients, the researchers noted.

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