Brett King, MD, on the Use of JAK Inhibitors and Granulomatous Diseases

Dr King discusses granulomatous diseases, the importance of effective therapy, and the use of Janus kinase inhibitors in treating autoimmune diseases.

Brett King, MD, is an associate professor of dermatology at the Yale University School of Medicine in New Haven, Connecticut.

TRANSCRIPT:

Hi. My name is Brett King. I am associate professor of dermatology at the Yale University School of Medicine in New Haven, Connecticut. Today, I am going to talk to you about JAK inhibitors.

In dermatology when we think about granulomatous disease, we think about granuloma annulare, and cutaneous sarcoidosis. Sarcoidosis has broad importance in medicine because it is typically a disease that affects the lungs. Less commonly, it can affect the heart, the brain, the liver, and relatively commonly, the skin.

Sarcoidosis presently has- the only FDA-approved medicine for it is prednisone. And that is for lung involvement. While TNF-alpha inhibitors and methotrexate are commonly used, these are frequently not efficacious. This is a disease that needs targeted reliably effective therapy.

In late 2018, we published the results of treatment of a patient with tofacitinib. Her skin disease, which was quite severe, completely vanished with tofacitinib. Since then, there have been numerous reports of patients treated with ruxolitinib, or tofacitinib, and whose internal organ disease has vanished in the same way that we see skin disease respond very well.

We are currently writing up the results of a 10-patient, open-label trial of tofacitinib in patients with skin disease, many or most of whom also had internal organ disease. The results of the study will be really fun to see.

As for granuloma annulare, we recently published an open-label trial of five patients treated with tofacitinib. All of these patients had refractory severe disease and most of them responded beautifully to treatment with tofacitinib.

I really think that we're learning both the pathophysiology from these studies, the pathophysiology of granulomatous diseases, but we're also learning that JAK inhibitors I think are going to be targeted therapy across a range of granulomatous diseases.

Thank you very much for your time. I hope that you've found this discussion of JAK inhibitors and their emerging role across medicine to be helpful and informative. Bye-bye.