Evidence map›Paper›PMID 39497828›Full record

ReviewFrontiers in immunology2024

Treatment and molecular analysis of bullous pemphigoid with tofacitinib: a case report and review of current literature.

Xiang Li, Lian Zhang, Hongzhi Gu, Wanzhen He, Zhifang Zhai, Mingwang Zhang

Abstract readCase ReportsReview
In one paragraph

Review in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Review
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  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xiang LiDepartment of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.
Lian ZhangDepartment of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.
Hongzhi GuDepartment of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.
Wanzhen HeDepartment of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.
Zhifang ZhaiDepartment of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.
Mingwang ZhangDepartment of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Bullous pemphigoid (BP) is a rare, life-threatening autoimmune blistering disease with pruritus and tension blisters/bullous as the main clinical manifestations. Glucocorticosteroids are the main therapeutic agents for it, but their efficacy is poor in some patients. Tofacitinib, a small molecule agent that inhibits JAK1/3, has shown incredible efficacy in a wide range of autoimmune diseases and maybe a new valuable treatment option for refractory BP. Objective: To report a case of refractory BP successfully treated with tofacitinib, then explore the underlying mechanism behind the treatment, and finally review similarities to other cases reported in the literature. Methods: Case report and literature review of published cases of successful BP treatment with JAK inhibitors. The case report describes a 73-year-old male with refractory BP that was successfully managed with the combination therapy of tofacitinib and low-dose glucocorticoids for 28 weeks. Immunohistochemistry and RNA sequencing were performed to analyze the underlying mechanism of tofacitinib therapy. A systematic literature search was conducted to identify other cases of treatment with JAK inhibitors. Results: Throughout the 28-week treatment period, the patient experienced clinical, autoantibody and histologic resolution. Immunohistochemical analysis showed tofacitinib significantly decreased the pSTAT3 and pSTAT6 levels in the skin lesions of this patient. RNA sequencing and immunohistochemical testing of lesion samples from other BP patients identified activation of the JAK-STAT signaling pathway. Literature review revealed 17 previously reported cases of BP treated with four kinds of JAK inhibitors successfully, including tofacitinib (10), baricitinib (1), upadacitinib (3) and abrocitinib (3). Conclusions: Our findings support the potential of tofacitinib as a safe and effective treatment option for BP. Larger studies are underway to better understand this efficacy and safety.

Indexed as

Pemphigoid, BullousPiperidinesPyrimidinesAgedDrug Therapy, CombinationGlucocorticoidsHumansJanus Kinase InhibitorsMaleTreatment OutcomeGlucocorticoidsJanus Kinase InhibitorsPiperidinesPyrimidinestofacitinibbullous pemphigoidcase reportJAK inhibitorJAK-STAT pathwaytofacitinib

Identifiers

PMID39497828
PMCPMC11532171

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.