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Successful Treatment of Eczema Using Rheumatoid Arthritis Drug Reported by Yale Physicians; Same Drug (Tofacitinib Citrate) Previously Also Found Useful in Vitiligo and Alopecia Areata

Researchers at Yale School of Medicine have successfully treated patients with moderate to severe eczema using a rheumatoid arthritis drug recently shown to reverse two other disfiguring skin conditions, vitiligo and alopecia areata. The study is evidence of a potential new era in eczema treatment, they report. The research findings were published online on July 17, 2015 in the Journal of the American Academy of Dermatology. The article is titled “Treatment of Recalcitrant Atopic Dermatitis with the Oral Janus Kinase Inhibitor Tofacitinib Citrate.” Eczema (atopic dermatitis) is a chronic condition that causes severe itching and leaves the skin red and thickened. It can adversely affect sleep and quality of life. Standard treatments, such as steroid creams and oral medicines, commonly fail to relieve symptoms in patients with moderate to severe eczema. Based on current scientific models of eczema biology, Yale Assistant Professor of Dermatology Brett King, M.D., Ph.D., hypothesized that a drug already approved for rheumatoid arthritis, tofacitinib citrate, would interrupt the immune response that causes eczema. The drug is an inhibitor of Janus kinase. In the new study, Dr. King and his colleagues report that treatment with the drug led to dramatic improvement in six patients with moderate to severe eczema who had previously tried conventional therapies without success. During treatment, all six patients reported significant reduction in itching, as well as improved sleep. The redness and thickening of the skin diminished, also. "These individuals were not only very happy with the results, they also expressed a tremendous sense of relief at being comfortable in their skin for the first time in many years," Dr. King said. Dr. King and fellow Yale dermatologist Brittany Craiglow, M.D., had previously shown that tofacitinib citrate regrows hair in patients with an autoimmune-related form of hair loss called alopecia areata. They also published findings reporting the successful treatment of a patient with vitiligo, which can leave widespread irregular white patches all over the body.

The new study suggests that a change in the standard of care for eczema -- a condition for which there is no targeted therapy -- may be on the horizon, say the researchers.

"Eczema affects millions of children and adults in the United States," said Dr. King. "I'm hopeful we are entering a whole new era in treatment."

The researchers note that further research is needed to confirm the treatment's long-term efficacy and safety for eczema patients.

Other Yale authors of the new study are Lauren L. Levy, M.D., and Jennifer Urban, M.D.

[Press release] [Journal of the American Academy of Dermatology abstract]