ARTHRITIS drug could transform the treatment of eczema, for which there is currently no targeted therapy, according to researchers who showed that it led to a substantial improvement in sufferers of the skin condition.
Researchers from the Yale School of Medicine, New Haven, Connecticut, USA, have detailed how they successfully used a rheumatoid arthritis drug to treat six patients with moderate-to-severe eczema. During treatment, all six patients – whose eczema had not responded to conventional treatments such as steroid creams and oral medicines – reported a significant decrease in itching, reduced redness and thickening of the skin, and improved sleep. Senior author Dr Brett King, Assistant Professor of Dermatology, Yale School of Medicine, reported: “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.”
Recent years have witnessed a shift in the debate concerning the causes of eczema, with mounting evidence suggesting that it may be an autoimmune disease. If so, then Dr King and colleagues were curious about testing whether tofacitinib citrate – a drug approved for treatment of rheumatoid arthritis – would disrupt the immune response that causes eczema. Dr King has been involved in two previous studies of the same drug: one showed that tofacitinib citrate may be used to treat the disfiguring skin condition vitiligo, and the other demonstrated how the drug helped a man with alopecia areata to grow a full head of hair.
Alopecia areata is an autoimmune disorder where the immune system targets the hair follicles. Vitiligo is also perceived to be an autoimmune disorder where the immune system attacks skin cells called melanocytes. Tofacitinib citrate blocks enzymes called Janus kinases (JAKs) that are involved in inflammation in rheumatoid arthritis – a chronic autoimmune disease that affects the lining of the joints. If unhindered, JAKs may signal the release of inflammatory cytokines that attack the joints and other tissues. The aim of rheumatoid arthritis treatment with tofacitinib is to decrease inflammation and disease activity.
Dr King said that the findings could transform treatment of eczema, concluding: “Eczema affects millions of children and adults in the United States. I am hopeful we are entering a whole new era in treatment.” However, Prof King and his colleagues acknowledged the need for further testing in order to confirm the safety and longer-term effectiveness of the treatment.