1
|
Yu F, Du D, Zhang Z, Shan X, Wang G, Bao F, Shi Z, Yang B, Zhang F. Oral Tofacitinib in the Treatment of Moderate-to-Severe Chronic Hand Eczema: A Case Series. Dermatitis 2024. [PMID: 38634838 DOI: 10.1089/derm.2024.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Affiliation(s)
- Fangzhou Yu
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Donghong Du
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Zhaoxia Zhang
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Xiaofeng Shan
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Guangjin Wang
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Fangfang Bao
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Zhongxiang Shi
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Baoqi Yang
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Furen Zhang
- Hospital for Skin Diseases, Shandong First Medical University, Jinan, Shandong Province, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| |
Collapse
|
2
|
Needle CD, Klein EJ, Gjonaj J, Nohria A, Karim M, Liu L, Shah J, Betensky RA, Garshick M, Lo Sicco K, Karagounis TK. Comparison of comorbidities and adverse events in dermatology and rheumatology patients prescribed tofacitinib: A retrospective analysis. J Am Acad Dermatol 2024; 90:659-662. [PMID: 38008410 PMCID: PMC10922818 DOI: 10.1016/j.jaad.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Carli D Needle
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Elizabeth J Klein
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Jessica Gjonaj
- Department of Biostatistics, NYU School of Global Public Health, New York, New York
| | - Ambika Nohria
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Maria Karim
- Division of Dermatology, Department of Internal Medicine, Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Lynn Liu
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Jinal Shah
- Department of Biostatistics, NYU School of Global Public Health, New York, New York
| | - Rebecca A Betensky
- Department of Biostatistics, NYU School of Global Public Health, New York, New York
| | - Michael Garshick
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York; Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Theodora K Karagounis
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York.
| |
Collapse
|
3
|
Bazargan AS, Jafarzadeh A, Nobari NN. Successful treatment of resistant plantar ulcerative lichen planus with tofacitinib: A case report and comprehensive review of the literature. Clin Case Rep 2023; 11:e8066. [PMID: 37854265 PMCID: PMC10580686 DOI: 10.1002/ccr3.8066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
Key Clinical Message Ulcerative lichen planus, a challenging variant of lichen planus, has limited response to traditional treatments. Tofacitinib, a JAK-STAT pathway inhibitor, shows promise in effectively treating these lesions. Abstract Lichen planus is a mucocutaneous disease that can cause various manifestations, such as itchy erythematous papules, cicatricial alopecia, erosion, and mucocutaneous ulcers. One uncommon manifestation of this disease is the occurrence of erosion and skin ulcers in the soles of the feet, which can cause many problems for patients. Tofacitinib, a Janus Kinase (JAK) inhibitor drug, has found a special place in the field of inflammatory diseases, especially inflammatory skin diseases. In this regard, studies on the effective role of this drug in the treatment of certain forms of lichen planus, including lichen planopilaris, and erosive lichen planus have been performed. In upcoming study, we introduce a 52-year-old woman with lichen planus who complained of ulcerative lesions on the sole of her foot, for whom a diagnosis of plantar ulcerative lichen planus was proposed. After the patient did not respond therapeutically to intralesional triamcinolone acetonide injection, as well as methotrexate and cyclosporine tablets, significant improvement was finally achieved with a 5 mg twice daily dose of tofacitinib. In the following, we will comprehensively review previous articles on the role of tofacitinib in the treatment of lichen planus lesions, as well as the proposed treatment options for erosive and ulcerative lichen planus lesions specifically located on the sole of the foot. Despite limited reports of the successful treatment of mucosal erosive lesions in the oral, esophageal, genital, and ocular mucosa areas with tofacitinib, no previous study has reported the successful treatment of ulcerative lichen planus lesions of the plantar area with tofacitinib. While reporting this case, we recommend considering tofacitinib as a treatment option for plantar ulcerative lichen planus. To confirm its effectiveness, it is necessary to conduct more extensive studies with a larger sample size.
Collapse
Affiliation(s)
- Afsaneh Sadeghzadeh Bazargan
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical Sciences (IUMS)TehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Alireza Jafarzadeh
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical Sciences (IUMS)TehranIran
| | - Niloufar Najar Nobari
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of MedicineIran University of Medical Sciences (IUMS)TehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| |
Collapse
|
4
|
Zhao YK, Lu JF, Liu JH, Wu HH, Song LL, Wan CL, Luo DQ. Recalcitrant nodular scabies showing excellent response to tofacitinib: five case reports. Ther Adv Chronic Dis 2023; 14:20406223231195632. [PMID: 37655266 PMCID: PMC10467300 DOI: 10.1177/20406223231195632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/21/2023] [Indexed: 09/02/2023] Open
Abstract
Scabies is a contagious skin condition caused by Sarcoptes scabiei, and it is always associated with an intense, unbearable, nocturnal deteriorating itch. Its presentations include classic burrows, erythema, pruritic papules, pustules, vesicles, and inflammatory nodules, with diffuse or localized distribution on the finger webs, wrist flexors, elbows, axillae, buttocks, genitalia, and breasts. Nodular scabies is an uncommon clinical variant of scabies. Its management is still challenging for some patients up to date, although topical, intralesional or systemic corticosteroids, topical calcineurin inhibitors, and crotamiton as well as cryotherapy alone or in different combinations are used. We here report five male patients of nodular scabies, aged between 14 and 25 years, who had classical scabies that had been cured by sulfur ointment for at least 4 weeks except for their itching nodules, and their residual pruritic nodules also failed in previous treatments including antihistamines, topical applying and intralesional injection of steroids as well as topical tacrolimus in different combinations before being recruited to this study. The patients were administered tofacitinib 5 mg, twice a day, which led to excellent and rapid improvement for both lesions and symptoms after 1-4 weeks of treatment, respectively, without any associations. During 6 months of follow-up, only one had re-infection of scabies associated with nodules that were cured by sulfur ointment and tofacitinib again. No adverse reaction was observed. The present results suggested that tofacitinib might be a potential agent for nodular scabies with excellent response.
Collapse
Affiliation(s)
- Yu-Kun Zhao
- Department of Dermatology, The East Division of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing-Fa Lu
- Department of Dermatology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Juan-Hua Liu
- Department of Dermatology, The East Division of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui-Hui Wu
- Department of Dermatology, The East Division of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lu-Li Song
- Department of Dermatology, The East Division of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chun-Lei Wan
- Department of Dermatology, The First Affiliated Hospital of Gannan Medical University, 23 Qingnian Rd., Ganzhou, Jiangxi Province 341000, China
| | - Di-Qing Luo
- Department of Dermatology, The East Division of The First Affiliated Hospital, Sun Yat-sen University, 183 Huangpu Rd. E., Guangzhou 510700, China
| |
Collapse
|
5
|
Ying Y, Yu-Hua L, Xiao-Yan W, Su-Chun H. A case of pityriasis rubra pilaris treated with tofacitinib after failure with acitretin and ixekizumab. Australas J Dermatol 2023; 64:445-447. [PMID: 37200390 DOI: 10.1111/ajd.14076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/12/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023]
Affiliation(s)
- Yang Ying
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Liu Yu-Hua
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Wu Xiao-Yan
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Hou Su-Chun
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
6
|
Guan Y, Yan A, Qiang W, Ruan R, Yang C, Ma K, Sun H, Liu M, Zhu H. Selective Delivery of Tofacitinib Citrate to Hair Follicles Using Lipid-Coated Calcium Carbonate Nanocarrier Controls Chemotherapy-Induced Alopecia Areata. Int J Mol Sci 2023; 24:ijms24098427. [PMID: 37176141 PMCID: PMC10179728 DOI: 10.3390/ijms24098427] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/24/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Chemotherapy-induced alopecia (CIA) is one of the common side effects in cancer treatment. The psychological distress caused by hair loss may cause patients to discontinue chemotherapy, affecting the efficacy of the treatment. The JAK inhibitor, Tofacitinib citrate (TFC), showed huge potential in therapeutic applications for treating baldness, but the systemic adverse effects of oral administration and low absorption rate at the target site limited its widespread application in alopecia. To overcome these problems, we designed phospholipid-calcium carbonate hybrid nanoparticles (PL/ACC NPs) for a topical application to target deliver TFC. The results proved that PL/ACC-TFC NPs showed excellent pH sensitivity and transdermal penetration in vitro. PL/ACC NPs offered an efficient follicular targeting approach to deliver TFC in a Cyclophosphamide (CYP)-induced alopecia areata mouse model. Compared to the topical application of TFC solution, PL/ACC-TFC NPs significantly inhibited apoptosis of mouse hair follicles and accelerated hair growth. These findings support that PL/ACC-TFC NPs has the potential for topical application in preventing and mitigating CYP-induced Alopecia areata.
Collapse
Affiliation(s)
- Yeneng Guan
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Aqin Yan
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Wei Qiang
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Rui Ruan
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Chaobo Yang
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Kai Ma
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Hongmei Sun
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Mingxing Liu
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| | - Hongda Zhu
- Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Key Laboratory of Fermentation Engineering (Ministry of Education), National "111" Center for Cellular Regulation and Molecular Pharmaceutics, School of Food and Biological Engineering, Hubei University of Technology, Wuhan 430068, China
| |
Collapse
|
7
|
Mansouri P, Mozafari N, Chalangari R, Martits-Chalangari K. Efficacy of oral tofacitinib in refractory chronic spontaneous urticaria and urticarial vasculitis. Dermatol Ther 2022; 35:e15932. [PMID: 36226796 DOI: 10.1111/dth.15932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/25/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022]
Abstract
The treatment of chronic urticaria (CU) is difficult, currently, antihistamines (AH) are the mainstay of treatment, however, up to 40% of patients do not respond to even high (four-fold) daily doses of AH. Tofacitinib is, a small-molecule that blocks JAK1/3 and inhibits intracellular signaling of multiple key cytokines involved in the inflammatory cascade and its beneficial effects were reported in patients with mast cell activation disease but there is no report in patients with urticaria. Here, we present four cases of refractory CU and one case of urticarial vasculitis (UV) that were managed with tofacitinib. Despite the long-term unresponsiveness of various treatments in our patients, the addition of tofacitinib significantly improved the urticarial activity and ultimately led to tapering and discontinuation of cyclosporine or AH. In conclusion, tofacitinib appears to downregulate inflammatory phenomena associated with mast cells and might be a new therapeutic option for patients with refractory CU or UV.
Collapse
Affiliation(s)
- Parvin Mansouri
- Medical Laser Research Centers, Academic Center of Education, Culture and Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikoo Mozafari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Chalangari
- Dermatology Department, Kassir Dermatology, Dallas, Texas, USA
| | | |
Collapse
|
8
|
Majid I, Akhtar S. Tofacitinib in resistant chronic actinic dermatitis: A case series. Dermatol Ther 2022; 35:e15467. [PMID: 35315968 DOI: 10.1111/dth.15467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Imran Majid
- Cutis Institute of Dermatology, Srinagar, Jammu and Kashmir, India
| | - Saniya Akhtar
- Cutis Institute of Dermatology, Srinagar, Jammu and Kashmir, India
| |
Collapse
|
9
|
Agarwal I, Panda M, Das A. Tofacitinib in pediatric dermatoses : a narrative review. Clin Exp Dermatol 2022; 47:1256-1264. [PMID: 35279865 DOI: 10.1111/ced.15175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/27/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ishan Agarwal
- Department of Dermatology, Venereology, and Leprosy; IMS and SUM Hospital Bhubaneshwar Odisha India
| | - Maitreyee Panda
- Department of Dermatology, Venereology, and Leprosy; IMS and SUM Hospital Bhubaneshwar Odisha India
| | - Anupam Das
- Department of Dermatology, Venereology, and Leprosy; KPC Medical College & Hospital Kolkata West Bengal India
| |
Collapse
|
10
|
Funk PJ, Perche PO, Singh R, Kelly KA, Feldman SR. Comparing available JAK inhibitors for treating patients with psoriasis. Expert Rev Clin Immunol 2022; 18:281-294. [DOI: 10.1080/1744666x.2022.2039121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Parker J. Funk
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Patrick O. Perche
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rohan Singh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Katherine A. Kelly
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Steven R. Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
11
|
Benton S, Farah R, Freese R, Hordinsky M. Tofacitinib as a pragmatic treatment choice for alopecia areata: A retrospective review. Dermatol Ther 2022; 35:e15310. [PMID: 34997820 DOI: 10.1111/dth.15310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/14/2021] [Accepted: 01/06/2022] [Indexed: 12/15/2022]
Abstract
Alopecia areata (AA) is an immune-mediated hair loss disease for which targeted immune treatments including janus kinase (JAK) inhibitors, e.g., tofacitinib, are emerging. More literature is needed on the safety and efficacy of JAK inhibitors, and treatment has the potential to be cost prohibitive. This study was conducted to measure safety and efficacy outcomes of off-label use of tofacitinib in AA. A secondary outcome was analysis of payment methods. We reviewed 35 AA patients treated with tofacitinib in a specialty hair disease clinic between January 2013 and July 2019 for outcomes, adverse events, and feasibility of treatment. No serious adverse events were experienced. 83.9% of patients experienced clinically significant scalp regrowth, and 32.3% experienced near total/total regrowth. Though this study was confined to retrospective analysis, the results showed that tofacitinib was safe, effective, and practical for this cohort of 35 AA patients.
Collapse
Affiliation(s)
- Sarah Benton
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ronda Farah
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Rebecca Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Maria Hordinsky
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
12
|
Fougerousse AC. At the Dawn of a Therapeutic Revolution for Atopic Dermatitis: An Interview with Dr Anne-Claire Fougerousse. Dermatol Ther (Heidelb) 2021; 11:331-338. [PMID: 33523410 PMCID: PMC7848038 DOI: 10.1007/s13555-021-00489-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Indexed: 11/30/2022] Open
Abstract
Dr Anne-Claire Fougerousse is Head of Dermatology at the Bégin Hospital in Saint-Mandé, France, and scientific coordinator of a French network of dermatologists and allergists (ResoEczema). The focus of her work is to improve the care of adolescent and adult patients with atopic dermatitis (AD), a chronic, pruritic inflammatory skin disease that substantially impacts patient quality of life. In this interview, Dr Fougerousse provides an overview of the clinical presentation of adult patients with AD and describes available treatments. Today, topical agents like emollients and corticosteroids are the mainstay of AD therapy, and patients with lesions that are resistant to optimally administered topical treatment can also receive phototherapy or systemic therapy with ciclosporin. Dr Fougerousse discusses her hopes for the future of AD therapy with the recent development of biologicals like dupilumab, which may provide improvements in clinical outcomes and quality of life for patients with moderate-to-severe AD. In the next few years, the therapeutic arsenal for AD will likely expand to include more systemic therapies providing sustained symptom control. The real challenge will be to ensure that the maximum number of patients with AD achieve clinical benefits from these new treatments.
Collapse
Affiliation(s)
- Anne-Claire Fougerousse
- Service de Dermatologie, Hôpital Bégin, Saint-Mandé, France. .,Groupe d'Etudes Multicentriques Reso, Saint-Maur-des-Fossés, France.
| |
Collapse
|
13
|
Christmann R, Ho DK, Wilzopolski J, Lee S, Koch M, Loretz B, Vogt T, Bäumer W, Schaefer UF, Lehr CM. Tofacitinib Loaded Squalenyl Nanoparticles for Targeted Follicular Delivery in Inflammatory Skin Diseases. Pharmaceutics 2020; 12:E1131. [PMID: 33255225 PMCID: PMC7760822 DOI: 10.3390/pharmaceutics12121131] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 01/05/2023] Open
Abstract
Tofacitinib (TFB), a Janus kinase inhibitor, has shown excellent success off-label in treating various dermatological diseases, especially alopecia areata (AA). However, TFB's safe and targeted delivery into hair follicles (HFs) is highly desirable due to its systemic adverse effects. Nanoparticles (NPs) can enhance targeted follicular drug delivery and minimize interfollicular permeation and thereby reduce systemic drug exposure. In this study, we report a facile method to assemble the stable and uniform 240 nm TFB loaded squalenyl derivative (SqD) nanoparticles (TFB SqD NPs) in aqueous solution, which allowed an excellent loading capacity (LC) of 20%. The SqD NPs showed an enhanced TFB delivery into HFs compared to the aqueous formulations of plain drug in an ex vivo pig ear model. Furthermore, the therapeutic efficacy of the TFB SqD NPs was studied in a mouse model of allergic dermatitis by ear swelling reduction and compared to TFB dissolved in a non-aqueous mixture of acetone and DMSO (7:1 v/v). Whereas such formulation would not be acceptable for use in the clinic, the TFB SqD NPs dispersed in water illustrated a better reduction in inflammatory effects than plain TFB's aqueous formulation, implying both encouraging good in vivo efficacy and safety. These findings support the potential of TFB SqD NPs for developing a long-term topical therapy of AA.
Collapse
Affiliation(s)
- Rebekka Christmann
- Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS)—Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany; (R.C.); (D.-K.H.); (S.L.); (B.L.)
- Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany;
| | - Duy-Khiet Ho
- Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS)—Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany; (R.C.); (D.-K.H.); (S.L.); (B.L.)
- Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany;
| | - Jenny Wilzopolski
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, 14195 Berlin, Germany; (J.W.); (W.B.)
| | - Sangeun Lee
- Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS)—Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany; (R.C.); (D.-K.H.); (S.L.); (B.L.)
| | - Marcus Koch
- INM-Leibniz Institute for New Materials, 66123 Saarbrücken, Germany;
| | - Brigitta Loretz
- Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS)—Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany; (R.C.); (D.-K.H.); (S.L.); (B.L.)
| | - Thomas Vogt
- Department of Dermatology, Saarland University Hospital, 66421 Homburg/Saar, Germany;
| | - Wolfgang Bäumer
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, 14195 Berlin, Germany; (J.W.); (W.B.)
| | - Ulrich F. Schaefer
- Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany;
| | - Claus-Michael Lehr
- Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS)—Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany; (R.C.); (D.-K.H.); (S.L.); (B.L.)
- Department of Pharmacy, Saarland University, 66123 Saarbrücken, Germany;
| |
Collapse
|
14
|
Goenaga-Vázquez Y, Lauck KC, Hebert AA. Therapeutic challenges in managing pediatric psoriasis. Int J Womens Dermatol 2020; 7:314-318. [PMID: 34222589 PMCID: PMC8243148 DOI: 10.1016/j.ijwd.2020.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/24/2020] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
Background Each year, 20,000 patients aged <10 years are diagnosed with psoriasis. Pediatric-onset psoriasis has many similarities to adult-onset disease, and previous studies suggest that the incidence might be increasing in both populations. Objective The challenges that arise when treating patients with psoriasis, especially those age <12 years, are summarized, as well as the limited available treatment options for treating pediatric patients with psoriasis and the evidence supporting each of them. Methods Recently published guidelines by the American Academy of Dermatology and the National Psoriasis Foundations, as well as guidelines published by the German Society of Dermatology, provide considerable insight in managing patients who have this condition. The latest studies on pediatric psoriasis treatment were reviewed, including recent and current clinical trials with U.S. Food and Drug Administration approved and nonapproved medications, case reports, case series, and reviews. The authors also reviewed American and European guidelines, as well as recommendations from expert panels. Results Currently, only six medications are approved by the U.S. Food and Drug Administration for the treatment of pediatric psoriasis: three biologics and three topical. Many off-label topical treatments have been used in pediatric psoriasis, with variable effectiveness and safety profiles. Data from adult clinical trials, as well as case reports and series from pediatric patients, suggest that other biologic medications are effective for pediatric psoriasis. Conclusion Many questions remain unanswered, leaving clinicians facing multiple challenges when encountering pediatric patients with psoriasis. This summation will help provide an overview of current on- and off-label medications for pediatric psoriasis. Pediatric clinical trials should be implemented to obtain data that can result in expanding the therapeutic spectrum for this population, parallel to their adult counterparts.
Collapse
Affiliation(s)
- Yamila Goenaga-Vázquez
- Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, United States
- Corresponding author.
| | - Kyle C. Lauck
- Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, United States
| | - Adelaide A. Hebert
- Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, United States
- Department of Pediatrics, UTHealth McGovern Medical School, Houston, TX, United States
| |
Collapse
|
15
|
Drug-Induced Neutropenia During Treatment of Non-Neoplastic Dermatologic Diseases: A Review. Clin Drug Investig 2020; 40:915-926. [PMID: 32691244 DOI: 10.1007/s40261-020-00956-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Idiosyncratic drug-induced neutropenia (DIN) is a rare, potentially fatal adverse reaction. A literature search was performed on Pubmed and Embase, targeting articles indicating neutropenia as a complication during the treatment of non-neoplastic dermatological disorders. In 66 identified articles, the common incriminated drugs included conventional oral immunomodulators, topical cytotoxic agents, antibacterials, antifungals, biologics and targeted synthetic disease-modifying antirheumatic drugs, non-steroidal anti-inflammatory drugs, and retinoids, with dapsone being reported most often. The duration of drug exposure before the diagnosis of neutropenia varied, but mostly ranged from days to weeks. The majority of patients recovered after drug discontinuation and supportive management including antibiotics and granulocyte colony-stimulating factor, but fatal cases were reported. The proposed pathogenesis of DIN consists of direct drug toxicity and immune-mediated reaction. Certain genetic variants, individual variability in enzyme efficiency, and concomitant use of other drugs may increase the risk of DIN. Being familiar with the most commonly implicated agents and risk factors helps early identification and prompt management of this potentially fatal complication.
Collapse
|
16
|
Two cases in which tofacitinib effectively treated both ulcerative colitis and alopecia areata. Clin J Gastroenterol 2020; 13:788-793. [PMID: 32592149 DOI: 10.1007/s12328-020-01150-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/29/2020] [Indexed: 12/16/2022]
Abstract
A 40-year-old woman (case 1) visited the hospital complaining of diarrhea and was diagnosed with ulcerative colitis (UC). She was administered 5-aminosalicylic acid (5-ASA), but developed intolerance. Prednisolone (PSL) was administered, and her symptoms improved. However, alopecia areata developed as the PSL was tapered, and her UC relapsed. Adalimumab, Infliximab (IFX), and golimumab were used, but all showed insufficient efficacy. Therefore, we started tofacitinib (TOF). Her bloody stools and diarrhea improved 3 days after TOF administration, and clinical remission occurred on day 14. Her alopecia areata improved 14 days after starting TOF and improved completely during TOF maintenance therapy. A 19-year-old man (case 2) had developed alopecia areata at 10 years old and was diagnosed with UC at 17 years old. He achieved sustained remission with IFX, but then stopped IFX to receive a live vaccination. His UC relapsed 4 months later, immediately after the live vaccine was administered. Vedolizumab was administered, but was ineffective, as was re-administration of IFX. TOF was administered, and his clinical symptoms improved 7 days later. He achieved clinical remission on day 20. In addition, his hair began to regrow 14 days after starting TOF.
Collapse
|
17
|
Aleisa AI, Plante JG, Hsia LLB. A case of aggressive squamous cell carcinoma with lymphovascular invasion during treatment with the Janus kinase inhibitor tofacitinib. JAAD Case Rep 2020; 6:727-730. [PMID: 32715063 PMCID: PMC7369521 DOI: 10.1016/j.jdcr.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ahmad I Aleisa
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.,Department of Dermatology, King Saud Medical City, Riyadh, Saudi Arabia
| | - John G Plante
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Ling-Lun B Hsia
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|