Hypereosinophilic syndrome—a rare adverse event of anti-cytokine treatment in rheumatoid arthritis resolved after Janus kinase inhibitor therapy

Since the introduction of immune modulators in the treatment of rheumatoid arthritis (RA), there has been hope that orally effective biologic agents would be developed. Tofacitinib, a Janus kinase inhibitor, has become the first oral biologic to receive approval for use in active RA patients. This paper reviews the efficacy and safety profile of Tofacitinib at dosages of 5 mg and 10 mg twice daily. Remarkable improvement in terms of ACR 20 response and HAQ-DI score was noted at month 3 and month 6. DAS 28-4 ESR < 2.6 achievement was noticeably obvious at month 6 for both dosages. No significant serious adverse events, serious infections, neutropenia, or anaemia were observed compared to placebo. In fact, Tofacitinib 5 mg was even found to have significant protective effect of anaemia in the meta-analysis (P=0.004). Tofacitinib has a noticeable efficacy in controlling disease activity in RA with a manageable safety profile. However, longer studies are needed for its long-term safety profile.

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Extensive Tinea Associated with Tofacitinib Therapy Masquerading as New-Onset SCLE

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.4.5.13 ◽

2020 ◽

Vol 4 (5) ◽

pp. 456-459

Author(s):

Connor R Buechler ◽

Elena Kurland ◽

Jesse Veenstra

Keyword(s):

Rheumatoid Arthritis ◽

Tinea Capitis ◽

Kinase Inhibitor ◽

Autoimmune Disorder ◽

Connective Tissue Disorder ◽

Janus Kinase ◽

Immunomodulatory Agents ◽

Janus Kinase Inhibitor ◽

Infection Monitoring ◽

New Onset

Rheumatoid arthritis is a chronic autoimmune disorder that often requires treatment with immunomodulatory agents, however, such interventions are not without risk of opportunistic infection. Monitoring for such conditions is critical, whereas recognition and treatment can prove challenging at times, as they may manifest with an atypical presentation or masquerade as another condition entirely. We present here a case of extensive tinea corporis with concomitant tinea capitis masquerading as new-onset connective tissue disorder in a patient being treated for rheumatoid arthritis with the Janus kinase inhibitor tofacitinib.

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Development of severe thrombocytopenia with TAFRO syndrome-like features in a patient with rheumatoid arthritis treated with a Janus kinase inhibitor

Medicine ◽

10.1097/md.0000000000022793 ◽

2020 ◽

Vol 99 (42) ◽

pp. e22793

Author(s):

Keiichiro Kadoba ◽

Daisuke Waki ◽

Keisuke Nishimura ◽

Hiroki Mukoyama ◽

Rintaro Saito ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Kinase Inhibitor ◽

Janus Kinase ◽

Severe Thrombocytopenia ◽

Janus Kinase Inhibitor ◽

Tafro Syndrome

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Chronic Myeloid Leukemia in a Patient Receiving Tofacitinib: A Case Report and Literature Review

Case Reports in Rheumatology ◽

10.1155/2019/2814504 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Georgio Medawar ◽

Joseph Chahrouri ◽

Rabih Said

Keyword(s):

Rheumatoid Arthritis ◽

Case Report ◽

Myeloid Leukemia ◽

Kinase Inhibitor ◽

Janus Kinase ◽

Myelogenous Leukemia ◽

Janus Kinase Inhibitor ◽

Case Presentation ◽

Rheumatologic Diseases ◽

Refractory Rheumatoid Arthritis

Background. Tofacitinib is a new oral Janus kinase inhibitor that has shown promising clinical benefit in various rheumatologic diseases. However, many concerns related to the development of malignancies have been reported with its use. Case Presentation. A 43-year-old female patient received tofacitinib for refractory rheumatoid arthritis (RA). Two years after 5 mg bid daily dosing, the patient developed chronic myelogenous leukemia (CML), for which she received imatinib and tofacitinib was discontinued. She then remained in remission for rheumatoid arthritis and within the expected milestone outcome for her CML. Conclusion. This is the first reported case of CML after the use of tofacitinib. This event is of particular interest knowing the possible benefits tofacitinib carries in the treatment of CML demonstrated in a few studies.

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