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Treatment of Multiorgan Sarcoidosis With Tofacitinib
Author(s) -
Damsky William,
Young Bryan D.,
Sloan Brett,
Miller Edward J.,
Obando J. Antonio,
King Brett
Publication year - 2020
Publication title -
acr open rheumatology
Language(s) - English
Resource type - Journals
ISSN - 2578-5745
DOI - 10.1002/acr2.11112
Subject(s) - tofacitinib , sarcoidosis , medicine , janus kinase , dermatology , immunology , cytokine , rheumatoid arthritis
Objective Sarcoidosis is an idiopathic inflammatory disorder that is difficult to treat. There is accumulating evidence that constitutive activation of Janus kinase–signal transducer and activator of transcription ( JAK ‐ STAT ) signaling occurs in sarcoidosis and represents a target for treatment. Here we report the efficacy of tofacitinib, a Janus kinase ( JAK ) inhibitor, in a single patient with multiorgan sarcoidosis. Methods A patient with long‐standing multiorgan sarcoidosis who was unresponsive to other commonly used therapies, including methotrexate, prednisone, and tumor necrosis factor α blockade, was treated with tofacitinib. Results Tofacitinib treatment resulted in clinical remission of cutaneous sarcoidosis lesions and resolution of positron emission tomography avid lesions in internal organs after 6 months. An evaluation of lesional tissue and blood before and during treatment showed resolution of granulomatous inflammation and normalization of disease biomarkers. Conclusion This case illustrates the promise of JAK inhibition as a strategy to treat recalcitrant sarcoidosis and suggests that further study of JAK inhibitors in sarcoidosis is needed.

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