Tofacitinib for refractory ocular mucous membrane pemphigoid

Abstract

Purpose: To report the successful use of tofacitinib in the treatment of refractory ocular mucous membrane pemphigoid (MMP). Observations: Two patients with ocular MMP presented with refractory disease after failure of multiple therapies. Treatment with tofacitinib led to durable control of conjunctival inflammation within 8 weeks and no apparent progression of sub-conjunctival fibrosis. One patient maintained absence of apparent disease activity over 16 months of follow-up. Cessation of tofacitinib in the other patient led to disease relapse which was reversed by re-initiation of therapy. Conclusions and importance: Small molecule inhibitors of Janus kinases, such as tofacitinib, may offer an effective treatment option for refractory ocular MMP.

Keywords

• Ocular cicatricial pemphigoid
• Mucous membrane pemphigoid
• Tofacitinib
• JAK
• STAT
• JAK inhibitor