Janus kinase (JAK) inhibitor baricitinib was found to be a successful treatment option for a patient with refractory eosinophilic fasciitis, according to a case report published in The Journal of Rheumatology.
A team of investigators from the Department of Rheumatology at Mayo Clinic in Rochester, Minnesota, assessed the outcomes in a 37-year-old man who was diagnosed with eosinophilic fasciitis via full-thickness skin biopsy.
The patient presented with peau d’orange with “groove signs” upon elevating his forearms and his blood count indicated an absolute eosinophil count of 2800. The patient was initially treated with intravenous methylprednisolone (1000 mg/d for 3 days), followed by prednisone (60 mg) and methotrexate (25 mg weekly) for 3 months. Daily mycophenolate mofetil (2 g) was administered in addition to the methotrexate for an additional 3 months, followed by monthly intravenous immunoglobulin for 3 months. However, no improvements were observed.
Using data from an ongoing randomized clinical trial (ClinicalTrials.gov Identifier: NCT03274076) assessing the role of JAK inhibitors in systemic sclerosis, the authors of this case report used baricitinib as a treatment option for refractory eosinophilic fasciitis in the patient.
Treatment with baricitinib was safe, cost-effective, reduced the use of corticosteroids, improved the Health Assessment Questionnaire II score from 2.5 to 1.0, reduced skin induration, and improved elasticity. Symptoms and skin appearance improved further after an additional 3 months.
“To our knowledge this is the first case of [eosinophilic fasciitis] treated successfully with baricitinib and supports growing interest in use of JAK inhibitors in sclerosing skin disorders,” the authors noted.
Segal R, Ernste FC, Eckloff S. Successful treatment with baricitinib in a patient with refractory eosinophilic fasciitis. J Rheumatol. 2021;48(6):948-949. doi:10.3899/jrheum.2009988