Tofacitinib for refractory ocular mucous membrane pemphigoid

Hayley James; Grace L Paley; Richard Brasington; Philip L Custer; Todd P Margolis; Michael A Paley

doi:10.1016/j.ajoc.2021.101104

Tofacitinib for refractory ocular mucous membrane pemphigoid

Am J Ophthalmol Case Rep. 2021 Apr 21:22:101104. doi: 10.1016/j.ajoc.2021.101104. eCollection 2021 Jun.

Authors

Hayley James¹, Grace L Paley¹, Richard Brasington^{1

2}, Philip L Custer¹, Todd P Margolis¹, Michael A Paley²

Affiliations

¹ Department of Ophthalmology and Visual Sciences, Washington University in Saint Louis, Center for Outpatient Health, 6th floor, 4901 Forest Park Avenue, Saint Louis, MO, 63110, USA.
² Division of Rheumatology, Department of Medicine, Washington University in Saint Louis, Center for Advanced Medicine, 5th floor Suite C, 4921 Parkview Place, Saint Louis, MO, 63110, USA.

Abstract

Purpose: To report the successful use of tofacitinib in the treatment of refractory ocular mucous membrane pemphigoid (MMP).

Observations: Two patients with ocular MMP presented with refractory disease after failure of multiple therapies. Treatment with tofacitinib led to durable control of conjunctival inflammation within 8 weeks and no apparent progression of sub-conjunctival fibrosis. One patient maintained absence of apparent disease activity over 16 months of follow-up. Cessation of tofacitinib in the other patient led to disease relapse which was reversed by re-initiation of therapy.

Conclusions and importance: Small molecule inhibitors of Janus kinases, such as tofacitinib, may offer an effective treatment option for refractory ocular MMP.

Keywords: JAK; JAK inhibitor; Mucous membrane pemphigoid; Ocular cicatricial pemphigoid; STAT; Tofacitinib.

Publication types

Case Reports