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Severe Cutaneous Sarcoid Responds to Tofacitinib

Researchers from Yale University in New Haven, Connecticut, demonstrated benefits to treating severe cutaneous sarcoidosis using tofacitinib (Xeljanz).

Their report in the New England Journal of Medicine described a female patient, age 48, who was previously unresponsive to multiple medications, and had not received systemic glucocorticoids. She was treated with tofacitinib 10 mg twice-daily and clinically responded with near disappearance of her skin lesions.

There is biologic rationale for this approach given that the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) signaling play a role in the pathogenesis of sarcoidosis. The authors performed RNA sequencing on biopsied lesions before and during treatment, and showed evidence of that the JAK-STAT pathway transitions from active to inactive. This finding, coupled with clinical and histologic remission of the patient’s skin disease, suggested the potential benefit of tofacitinib.

Jack Cush, MD, is the director of clinical rheumatology at the Baylor Research Institute and a professor of medicine and rheumatology at Baylor University Medical Center in Dallas. He is the executive editor of A version of this article first appeared on RheumNow, a news, information, and commentary site dedicated to the field of rheumatology. Register to receive their free rheumatology newsletter.