Extended-release tofacitinib for refractory Behçet disease: A case report. Issue 15 (15th April 2022)

• Record Type: Journal Article
• Authors: Wang, Chrong-Reen; Wong, Tak-Wah; Hsu, Sheng-Min
• Editors: Saranathan., Maya
• Is Part Of: Medicine. Volume 101:Issue 15(2022)
• Page Start: e29189
• Publication Date: 2022-04-15
• Subjects: Behçet disease -- extended-release tofacitinib -- JAK inhibitor -- Th1/Th17-type cytokines; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000029189
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Although single-cytokine inhibitors can be considered in treating severe or refractory Behçet disease (BD), these biologic agents are associated with potential therapeutic failure due to the multi-cytokine pathogenesis involving Th1- and Th17-type cytokines with activated Janus kinase/signal transducer and activator of transcription signaling pathways. Notably, there is an increasing trend toward the use of small-molecule targeted drug tofacitinib (TOF), a pan-Janus kinase inhibitor, with immediate-release formulations for treating patients with severe or refractory systemic vasculitis involving different vessel sizes. Despite no reported efficacy of extended-release formulations in refractory BD yet, such a dosage form has pharmacokinetic parameters that are comparable to those of conventional immediate-release formulations. Patient concerns and diagnosis: We report the case of a 27-year-old local woman with recurrent manifestations of arthritis, orogential ulcerations, papulopustular lesions, and anterior uveitis. She was diagnosed with BD for more than 3 years, and received long-term corticosteroids plus immunosuppressants therapy with the complication of opportunistic candidiasis infection. Interventions and outcomes: Under extended-release TOF 11 mg once-daily therapy, the patient achieved disease remission while sparing the use of corticosteroids during follow-up. Lessons: Our clinical observations implicate the oral convenience and therapeutic efficacy of extended-release TOF formulations in controlling the disease activity of BD.