Usage of Tofacitinib as a Steroid-sparing Therapy in Pulmonary and Cutaneous Sarcoidosis
Hazem Ahmed Moursi
Department of Pulmonology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Dalia Farrag Gomaa Ali
Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Sarcoidosis is a multisystem, granulomatous & chronic illness which typically affecting lymph nodes & lungs also any organ system. We aimed to evaluate the tofacitinib effectiveness as cutaneous & pulmonary sarcoidosis steroid-sparing treatment.
Methods: This retrospective cohort observational research was performed on 45 cases aged from 20 to 65 years old, both sexes, a forced vital capacity (FVC) >50%, histology consistent with sarcoidosis, pulmonary sarcoidosis definition by association for Sarcoidosis and other Granulomatous Disorders (WASOG) & disease progression or symptoms necessitating 15-30 mg/day prednisone (or comparable corticosteroids) as a consistent dose of for at least 4 weeks before enrolment. The definition of Steroid-dependent disease was the necessity for steroids for disease symptoms or progression control, but pulmonary impairment on pulmonary function testing was not required. Additionally, all instances with a history of failed attempts to reduce corticosteroid doses, and their treating physicians urged steroid-sparing therapy.
Results: Pulmonary function tests (FVC, FEV1, FEV1/ FVC ratio) were significantly improved after treatment compared to baseline (P value <0.001). 41 (91.1%) patients showed pulmonary improvement. The last evaluated CSAMI activity score was significantly lower compared to baseline CSAMI activity score (6.38 ± 2.7 vs. 39.51 ± 14.1, P <0.001). The mean CSAMI activity score decrease was 33.13± 11.4%.
Conclusions: Tofacitinib is a promising strategy for of cutaneous & pulmonary sarcoidosis treatment.
Keywords: Tofacitinib, steroid-sparing therapy, pulmonary, cutaneous, sarcoidosis